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Men and boys with Duchenne muscular dystrophy may be suffering with bladder problems unnecessarily, a UK study has found. Symptoms of detrusor hyperreflexia, at least, can be treated successfully.
A chance finding of reported urinary problems in the condition alerted doctors at a paediatric neurology unit to a need to investigate further.
More than half (46/74) of 88 males aged 3–31 years with Duchenne muscular dystrophy at one neuromuscular clinic had urinary problems not previously raised with their doctors. These included daytime and night time incontinence, frequency, urgency, hesitancy, and stress incontinence and covered young boys able to walk and older males using wheelchairs. Twenty one males with symptoms were offered kidney and bladder ultrasonography before and after bladder emptying and videourodynamic tests to isolate the nature of the problem. Of the 10 who opted for both investigations, nine had results suggesting detrusor hyperreflexia; seven of them had a small bladder. Five with similar symptoms opted just for ultrasonography. The ultrasonographic studies confirmed complete emptying of the bladder in all patients. All reported symptoms improved significantly and night time incontinence resolved with oxybutinin treatment in 10 males (seven and three, respectively, from each group). The neurological reasons for the urinary symptoms were unclear.
Urinary problems are not generally recognised with Duchenne muscular dystrophy among doctors, and parents assume they are part and parcel of the condition.