Objectives/Aims Functional neurological disorders are the second most common reason for outpatient review by a neurologist. The frequency of lower urinary tract symptoms in functional neurological disorders has not been described.
Our aim was to carry out a deep phenotyping of patients diagnosed with functional motor and/or dissociative symptoms and to record the prevalence of lower urinary tract dysfunction.
Methods A retrospective notes review was undertaken involving consecutive patients attending a specialist functional neurological disorders clinic in Edinburgh between October 2019-February 2020 for non-urological presentation.
Results In a one hundred and fifty-eight patient cohort, 78% of patients were female (n=123) and the mean age was 42. When categorising predominant functional symptoms, 52% of patients had a purely motor disorder (n=82), 17% of patients had a dissociative disorder alone (n=27) and 31% a mixed motor and dissociative disorder (n=49). Fifty percent of patients reported urinary symptoms (n=79). In total, 28% reported storage symptoms (n=45), 9% voiding symptoms (n=15), and 9% had mixed storage and voiding symptoms (n=15).
15% of patients attended a specialist clinic regarding their urinary symptoms (n= 23).
Patients with a motor disorder had the highest prevalence of lower urinary tract dysfunction (56%) and the dissociative group the lowest (26%). Storage symptoms were the most prevalent symptom (35% in motor, 15% in dissociative, 24% in mixed) and patients with storage or mixed LUTS were most likely to have a motor disorder (n=29, 64%; n=12, 80%), whereas those with voiding symptoms were more likely to have mixed functional neurological symptoms (n=10, 67%).
20% of patients reported urinary retention and/or voiding dysfunction (n = 32). 100% of these patients had motor or mixed symptoms.
11% of patients reported urinary retention (n=17) comprising 14 females and 3 men, with an average age of 36.4. 59% of patients with urinary retention were on opioid medication.
Conclusions 50% of patients with functional neurological disorders report lower urinary tract dysfunction however just 15% of patients attended a specialist clinic regarding their urinary symptoms.
This research has provided an insight into the potential associations between urological symptoms and functional neurology and may impact or change future management.
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