Harntraktfunktionsstörungen bei Guillain-Barré-Syndrom

Abstract

Guillain-Barré syndrome (GBS) as acute inflammatory demyelinating polyradiculoneuropathy frequently leads to lower urinary tract dysfunction. The available knowledge in the medical literature is limited and good recommendations for diagnosis and therapy are rare. In this study, 189 patients with GBS were screened for lower urinary tract dysfunction. In symptomatic patients, aurodynamic study was performed. Detrusor contractility, post-void residual, and changes of the symptoms over time were studied. Overall Barthel index and urinary control Barthel index as well as the relationship of time after onset of the disease and post-void residual were studied as possible screening criteria for urodynamic assessment. According to the urinary control Barthel index (BI), 115 of 189 patients (61%) presented lower urinary tract symptoms sometime during the course of disease. In 28patients, these symptoms were temporary during the acute phase. At the time of urological assessment, 87patients had lower urinary tract symptoms. At the end of rehabilitation, 37had no symptoms anymore (BI10), 20were able to control micturition to acertain extent (BI5), and 30had no lower urinary tract control (BI0). There was asignificant negative correlation between post-void residual volume and overall BI (ρ -0.5823, p< 0.0001) and BI for urinary tract control (ρ -0.6430, p< 0.0001). Overall BI and BI for urinary tract control are suitable screening criteria for urodynamic assessment.