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Declemy A, Haddad R, Chesnel C, Charlanes A, Le Breton F, Sheikh Ismael S, Amarenco G. Prevalence of comorbidities in multiple sclerosis patients with neurogenic bladder. Prog Urol 2021; 31:732-738. [PMID: 33941463 DOI: 10.1016/j.purol.2020.10.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/11/2020] [Accepted: 10/30/2020] [Indexed: 01/22/2023]
Abstract
AIMS The aim of this study was to define the prevalence of comorbidities among multiple sclerosis patients with lower urinary tract symptoms. METHODS A retrospective study of data collected prospectively from January 2000 to March 2016 was carried out using a database. Comorbidities were divided into several classes according to the International Classification of Diseases (ICD-10). RESULTS One hundred and fifty-five patients were included. All had a neurogenic bladder with 150 (96%) overactive bladder. EDSS score was≥6 in 44 patients (28%). Comorbidities were present in 79 (50,9%) and the most frequent ones were cardiovascular (14,2%), endocrinological (10,3%), urological (8,4%), abdominal (7,7%). Overweight (BMI≥25) was observed in 63 (40%). A strict relationship was found for BMI and stress urinary incontinence (P<0.001) as well as voiding dysfunction (P=0.003) without significant association for BMI and overactive bladder. CONCLUSION Prevalence of comorbidities is important in MS (more than 50%). A significant association is found between overweight, stress urinary incontinence and voiding dysfunction. Knowledge of these comorbidities in MS is important since the presence of these urinary symptoms not related to neurogenic bladder must lead to a specific treatment. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- A Declemy
- GREEN GRC-01 UPMC (Group of clinical REsEarch in Neuro-urology), Sorbonne University, Paris, France; Department of Neuro-urology, Tenon Hospital, APHP, Paris, France.
| | - R Haddad
- GREEN GRC-01 UPMC (Group of clinical REsEarch in Neuro-urology), Sorbonne University, Paris, France; Department of Neuro-urology, Tenon Hospital, APHP, Paris, France
| | - C Chesnel
- GREEN GRC-01 UPMC (Group of clinical REsEarch in Neuro-urology), Sorbonne University, Paris, France; Department of Neuro-urology, Tenon Hospital, APHP, Paris, France
| | - A Charlanes
- GREEN GRC-01 UPMC (Group of clinical REsEarch in Neuro-urology), Sorbonne University, Paris, France; Department of Neuro-urology, Tenon Hospital, APHP, Paris, France
| | - F Le Breton
- GREEN GRC-01 UPMC (Group of clinical REsEarch in Neuro-urology), Sorbonne University, Paris, France; Department of Neuro-urology, Tenon Hospital, APHP, Paris, France
| | - S Sheikh Ismael
- GREEN GRC-01 UPMC (Group of clinical REsEarch in Neuro-urology), Sorbonne University, Paris, France; Department of Neuro-urology, Tenon Hospital, APHP, Paris, France
| | - G Amarenco
- GREEN GRC-01 UPMC (Group of clinical REsEarch in Neuro-urology), Sorbonne University, Paris, France; Department of Neuro-urology, Tenon Hospital, APHP, Paris, France
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Declemy A, Chesnel C, Charlanes A, Le Breton F, Sheikh Ismael S, Amarenco G. Short-term reproducibility of cystometry in multiple sclerosis patients. Prog Urol 2020; 31:169-174. [PMID: 33309471 DOI: 10.1016/j.purol.2020.11.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/11/2020] [Accepted: 11/12/2020] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To assess the reproducibility of detrusor activity cystometric pattern in multiple sclerosis (MS) patients, which is poorly documented in the medical literature, by means of successive filling. METHODS We conducted a prospective study in MS patients; cystometry was repeated twice at 5minutes of interval if a detrusor overactivity before 300mL of filling was observed. Thus, 3 successive cystometries were analysed. The following characteristics were recorded: detrusor maximum pressure (Pmax), volume at the first involuntary detrusor contraction (IDC), maximum cystometric capacity (MCC), pressure at the first IDC, the existence of an overactive detrusor classified as phasic or terminal. RESULTS We included 31 patients (19 women and 12 men); only 6 patients were naïve-treatment, the mean EDSS was: 5.3 (±1.6) and the mean age was 48.4 (±12.5) years. All the patients had an overactive detrusor for each cystometry. The reproducibility was good for all the parameters (range ICC between 0.7 and 0.83). CONCLUSION Quantitative and qualitative cystometric data have a good reproducibility in MS patients with detrusor overactivity before 300mL of filling. LEVEL OF PROOF 3.
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Affiliation(s)
- A Declemy
- Sorbonne université, GRC 01, GREEN - groupe de recherche clinique en neuro-urologie, AP-HP, hôpital Tenon, 75020 Paris, France; Department of neuro-urology, Tenon hospital, AP-HP, 75020 Paris, France.
| | - C Chesnel
- Sorbonne université, GRC 01, GREEN - groupe de recherche clinique en neuro-urologie, AP-HP, hôpital Tenon, 75020 Paris, France; Department of neuro-urology, Tenon hospital, AP-HP, 75020 Paris, France
| | - A Charlanes
- Sorbonne université, GRC 01, GREEN - groupe de recherche clinique en neuro-urologie, AP-HP, hôpital Tenon, 75020 Paris, France; Department of neuro-urology, Tenon hospital, AP-HP, 75020 Paris, France
| | - F Le Breton
- Sorbonne université, GRC 01, GREEN - groupe de recherche clinique en neuro-urologie, AP-HP, hôpital Tenon, 75020 Paris, France; Department of neuro-urology, Tenon hospital, AP-HP, 75020 Paris, France
| | - S Sheikh Ismael
- Sorbonne université, GRC 01, GREEN - groupe de recherche clinique en neuro-urologie, AP-HP, hôpital Tenon, 75020 Paris, France; Department of neuro-urology, Tenon hospital, AP-HP, 75020 Paris, France
| | - G Amarenco
- Sorbonne université, GRC 01, GREEN - groupe de recherche clinique en neuro-urologie, AP-HP, hôpital Tenon, 75020 Paris, France; Department of neuro-urology, Tenon hospital, AP-HP, 75020 Paris, France
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Coindreau V, Chesnel C, Babany F, Declemy A, Savard E, Charlanes A, Lebreton F, Amarenco G. [Urinary tract symptoms in Lewy body dementia: About 19 cases]. Prog Urol 2020; 30:267-272. [PMID: 32224094 DOI: 10.1016/j.purol.2020.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 02/10/2020] [Accepted: 02/13/2020] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Lewy Body Dementia (LBD) is a Parkinsonian disorder which often leads to Lower Urinary Tract Symptoms (LUTS), especially an Overactive Bladder (OAB). There have been few LBD related LUTS depictions in the literature, which is why we did this retrospective study. METHODS Retrospective single institution study. RESULTS Nineteen patients with confirmed LBD diagnosis were found, (63% of men, mean age 74 years old). The main symptom was OAB (100% of patients) with frequent stress urinary incontinence (94%) associated with detrusor overactivity (93%) with pressure elevation (79%). Voiding difficulties were found in 16% of medical interviews, and in 53% of urodynamics. In total, 92% of patients complained of constipation, with 44% suffering from fecal incontinence. DISCUSSION LBD is characterized by alpha-synuclein aggregates in the cerebral cortex, thus explaining associated cognitive impairment. The most commonly found LUTS is stress incontinence. We also found voiding difficulties in smaller proportion, sometimes associated with prostatism. Topographically, these symptoms could be explained by alpha-synuclein aggregates in the frontal and temporal cortex and the pons. Anorectal disorder and sexual dysfunction were frequently associated. Urological complications are scarce in this population, screening is focused in increasing quality of life, and the possibility to discriminate the different types of Parkinsonisms. CONCLUSION OAB is the most common lower urinary tract symptom in LBD often associated with detrusor overactivity, and less frequently voiding difficulties sometimes associated to prostatism. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- V Coindreau
- Groupe de recherche clinique en neuro-urologie (GREEN GRC-01 UPMC), Sorbonne universités, 75005 Paris, France; Service de neuro-urologie, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France.
| | - C Chesnel
- Groupe de recherche clinique en neuro-urologie (GREEN GRC-01 UPMC), Sorbonne universités, 75005 Paris, France; Service de neuro-urologie, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - F Babany
- Groupe de recherche clinique en neuro-urologie (GREEN GRC-01 UPMC), Sorbonne universités, 75005 Paris, France; Service de neuro-urologie, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - A Declemy
- Groupe de recherche clinique en neuro-urologie (GREEN GRC-01 UPMC), Sorbonne universités, 75005 Paris, France; Service de neuro-urologie, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - E Savard
- Groupe de recherche clinique en neuro-urologie (GREEN GRC-01 UPMC), Sorbonne universités, 75005 Paris, France; Service de neuro-urologie, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - A Charlanes
- Groupe de recherche clinique en neuro-urologie (GREEN GRC-01 UPMC), Sorbonne universités, 75005 Paris, France; Service de neuro-urologie, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - F Lebreton
- Groupe de recherche clinique en neuro-urologie (GREEN GRC-01 UPMC), Sorbonne universités, 75005 Paris, France; Service de neuro-urologie, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - G Amarenco
- Groupe de recherche clinique en neuro-urologie (GREEN GRC-01 UPMC), Sorbonne universités, 75005 Paris, France; Service de neuro-urologie, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France
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Savard E, Chesnel C, Declemy A, Hentzen C, Charlanes A, Le Breton F, Amarenco G. Effect of need to void on Parkinsonian gait. Prog Urol 2020; 30:390-395. [PMID: 32156452 DOI: 10.1016/j.purol.2020.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 02/13/2020] [Accepted: 02/16/2020] [Indexed: 11/26/2022]
Abstract
AIMS Beside motor control alteration and tremor, the main symptoms in Parkinsonian disorders, lower urinary tract dysfunction is very common and thus often associated with gait disorder. No studies have assessed their association yet. The aim of this study was to assess the effect of the need to void on walking speed in this particular population. The secondary aim was to assess the effect of desire to void in a double task condition on the walking speed, and on the time to raise up from the floor. METHODS This prospective study included all Parkinsonian disorders who had a follow-up for overactive bladder (OAB). We invited them to drink until a desire to void or equivalent (DV), then they performed three ten-meters walk tests, one double-task ten-meters walk test, one timed-up-and-go test (TUG), one timed raise of the floor (GMT). We repeated the same tests just after bladder emptying. RESULTS Nine men and two women (age 69±6) were included in the study (seven Parkinson's Diseases, two multisystem atrophies, two not yet characterized). Mean scores of UPDRS-III were 17±6.5, Hoehn & Yahr scale were 1.9±0.7, time since onset 7±4.4 years, levodopa daily equivalent 691±478mg. Patients performed the walking tests at DV with a mean bladder volume from 220±189mL. The mean speed was 1m/s at DV and 1.1m/s at PV (P<0.001). TUG was also increased for patients at DV: mean 9.8 s at DV versus 8.8sec at PV (P<0.003). CONCLUSION In Parkinsonian disorders, need to void may impact the walking speed, a strong desire to void worsening gait velocity. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- E Savard
- GREEN GRC-01 UPMC: Group of clinical REsEarch in Neurourology, faculté de médecine, Sorbonne Unviersité, hôpital universitaire Tenon, Assistance publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France.
| | - C Chesnel
- GREEN GRC-01 UPMC: Group of clinical REsEarch in Neurourology, faculté de médecine, Sorbonne Unviersité, hôpital universitaire Tenon, Assistance publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France
| | - A Declemy
- GREEN GRC-01 UPMC: Group of clinical REsEarch in Neurourology, faculté de médecine, Sorbonne Unviersité, hôpital universitaire Tenon, Assistance publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France
| | - C Hentzen
- GREEN GRC-01 UPMC: Group of clinical REsEarch in Neurourology, faculté de médecine, Sorbonne Unviersité, hôpital universitaire Tenon, Assistance publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France
| | - A Charlanes
- GREEN GRC-01 UPMC: Group of clinical REsEarch in Neurourology, faculté de médecine, Sorbonne Unviersité, hôpital universitaire Tenon, Assistance publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France
| | - F Le Breton
- GREEN GRC-01 UPMC: Group of clinical REsEarch in Neurourology, faculté de médecine, Sorbonne Unviersité, hôpital universitaire Tenon, Assistance publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France
| | - G Amarenco
- GREEN GRC-01 UPMC: Group of clinical REsEarch in Neurourology, faculté de médecine, Sorbonne Unviersité, hôpital universitaire Tenon, Assistance publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France
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Chesnel C, Charlanes A, Declemy A, Le Breton F, Kerdraon J, Sheikh Ismael S, Amarenco G. Emptying cystometry: A feasibility and validation pilot study on female patients. Prog Urol 2018; 28:542-547. [PMID: 30017704 DOI: 10.1016/j.purol.2018.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 05/25/2018] [Accepted: 06/13/2018] [Indexed: 11/17/2022]
Abstract
INTRODUCTION To assess the feasibility and the accuracy of emptying cystometry in order to simplify the manometric follow-up of overactive detrusor in neurological patients under anticholinergic or botulinum toxin injections. MATERIAL Female patients with a stable detrusor underwent both a conventional cystometry and sequential measurements of bladder pressure during emptying (emptying cystometry). At the end of the standard cystometry, a CH12 urinary catheter was introduced in the bladder and was connected to a three-way stopcock. The second way of the stopcock permitted the emptying. The third way of the stopcock was connected to a vertical graduated tube to measure the bladder pressure each 50mL during the bladder emptying. RESULTS Eleven female patients were included (mean age: 59.4years). Nine patients (82%) had neurogenic bladder. Mean cystometric capacity was 439mL (SD: 35mL). During the emptying cystometry, 8 to 10 measures were taken (mean: 9.4). The mean detrusor pressure was 1.7cmH2O (SD 2.1) for the filling cystometry and 2.3cmH2O (SD: 2.7) for the emptying cystometry. The agreement between the detrusor pressure between the two cystometries was good with intra-class correlation coefficient at 0.66 [0.48-0.77] - and the correlation was high (r=0.7; P<0.000001). CONCLUSION In a small, selected sample of patients, emptying cystometry provides similar results of detrusor pressure to filling cystometry. This technique could constitute a home monitoring of bladder pressures in a selected population of patients with intermittent catheterization in whom a manometric follow-up of detrusor overactivity is required. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- C Chesnel
- GREEN GRC-01 UPMC (Group of clinical Research in Neuro-urology), Sorbonne University, Paris, France; Department of Neuro-urology, Tenon Hospital, AP-HP, 4, rue de la Chine, 75020 Paris, France.
| | - A Charlanes
- GREEN GRC-01 UPMC (Group of clinical Research in Neuro-urology), Sorbonne University, Paris, France; Department of Neuro-urology, Tenon Hospital, AP-HP, 4, rue de la Chine, 75020 Paris, France.
| | - A Declemy
- GREEN GRC-01 UPMC (Group of clinical Research in Neuro-urology), Sorbonne University, Paris, France; Department of Neuro-urology, Tenon Hospital, AP-HP, 4, rue de la Chine, 75020 Paris, France.
| | - F Le Breton
- GREEN GRC-01 UPMC (Group of clinical Research in Neuro-urology), Sorbonne University, Paris, France; Department of Neuro-urology, Tenon Hospital, AP-HP, 4, rue de la Chine, 75020 Paris, France.
| | - J Kerdraon
- GREEN GRC-01 UPMC (Group of clinical Research in Neuro-urology), Sorbonne University, Paris, France; Department of Physical Medicine and Rehabilitation, Kerpape Ploemeur Hospital, Ploemeur, France.
| | - S Sheikh Ismael
- GREEN GRC-01 UPMC (Group of clinical Research in Neuro-urology), Sorbonne University, Paris, France; Department of Neuro-urology, Tenon Hospital, AP-HP, 4, rue de la Chine, 75020 Paris, France.
| | - G Amarenco
- GREEN GRC-01 UPMC (Group of clinical Research in Neuro-urology), Sorbonne University, Paris, France; Department of Neuro-urology, Tenon Hospital, AP-HP, 4, rue de la Chine, 75020 Paris, France.
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Mathevon L, Declemy A, Laffont I, Pérennou D. Immunogenicity after botulinum toxin injections for limb spasticity: Myth or reality? Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Jaouen M, Declemy A, Rachman A, Laplanche G. On the two-photon ionisation of atomic caesium via quadrupole 6D3/2-6D5/2resonances: fine-structure effects and electron spin polarisation. ACTA ACUST UNITED AC 1999. [DOI: 10.1088/0022-3700/13/23/005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Rullière C, Declemy A, Pée P. Réalisation d'un spectromètre d'absorption « picoseconde » monofaisceau. Application à la dynamique des états excités des molécules organiques. ACTA ACUST UNITED AC 1983. [DOI: 10.1051/rphysap:01983001806034700] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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