The impact of myasthenia gravis on lower urinary tract functions

Abstract

Aim To assess the functions of the lower urinary tract (LUT) in patients with myasthenia gravis (MG). Materials and Methods A total of 36 patients (18 males and 18 females) with MG and 29 healthy controls were enrolled. Participants completed a 3‐day voiding diary and responded to questionnaires "Overactive Bladder Symptom Score" (OABSS) and "International Consultation on Incontinence‐Short Form" (ICIQ‐SF). All patients underwent uroflowmetry and ultrasonography (US). The data were compared based on the onset of disease and serological status. Results The most common urinary symptoms were nocturia (80.5%), incontinence (61%) and urgency (47%). OABSS was higher in patients than controls (P = .008). Duration of urinary symptoms was longer, and nocturia was more common in late‐onset MG (LOMG) than in early‐onset MG (EOMG; P = .029, P = .023). The duration of disease and urinary symptoms statistically increased in ACh‐Ab (−) group compared with ACh‐Ab (+) group (P = .003, P = .027). Night‐time urination frequency significantly increased while daytime voided volume (VV) decreased in LOMG compared with EOMG (P = .003 and P = .01). Residual volume on the US was significantly higher in LOMG than that in EOMG (P = .004). The duration of disease was positively correlated with tQmax and daytime urination frequency (P = .013, r = .48; P = .016, r = .398). A negative association was found between duration of disease and daytime VV (P = .04, r = −.344). Conclusion LUT dysfunction may manifest disease in MG, particularly in late‐onset forms. The lack of ACh‐Ab seemed to prolong the duration of disease and urinary disturbances.

Urinary incontinence as a possible signal of neuromuscular toxicity during immune checkpoint inhibitor treatment: Case report and retrospective pharmacovigilance study

“…Myasthenia gravis can predispose individuals to a higher risk of urinary incontinence by affecting the tone of the smooth or striated muscle of the distal sphincter (5). The frequency of urinary incontinence was significantly higher in patients with myasthenia gravis than in controls (26,27). Sandler et al concluded that voiding dysfunction heralded either a new diagnosis of myasthenia gravis or an exacerbation of the disease process (28).…”