{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T03:51:18Z","timestamp":1788839478252,"version":"build-2803163510"},"reference-count":49,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2006,3,1]],"date-time":"2006-03-01T00:00:00Z","timestamp":1141171200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Movement Disorders"],"published-print":{"date-parts":[[2006,6,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Neurogenic urinary retention can be a major cause of morbidity in multiple\u2010system atrophy (MSA). However, the timing of its appearance has not been entirely clear, and neither have the medical and surgical modalities for managing patients. We present the data obtained from our uroneurological assessment and therapeutic interventions at various stages of MSA. We recruited 245 patients with probable MSA. We measured postvoid residuals (PVR) and performed EMG cystometry in all patients. The grand average volume of PVR was 140 mL (range, 0\u2013760) in our patients. The average PVR volume was 71 mL in the first year, increasing to 129 mL in the second year and 170 mL by the fifth year. The percentages of patients with complete urinary retention, acontractile detrusor, and detrusor\u2013sphincter dyssynergia (DSD) also increased. The increase in PVR resulted in a decrease in functional bladder capacity, together with an increase in detrusor overactivity and neurogenic sphincter EMG. Clean intermittent self\u2010catheterization (CISC) was introduced in most patients. Bladder\u2010oriented therapy (cholinergic agents) had a limited value, whereas urethra\u2010oriented therapy benefited patients with DSD (surgery) for up to 2 years, but syncope occurred in a subset of patients (\u03b1\u2010blockers). MSA patients present with large PVR by the second year of illness, and that large PVR secondarily causes urinary frequency. CISC is the recommended treatment for most patients. Urethra\u2010oriented medication and surgery benefit patients who would have difficulty performing CISC, although careful consideration of the short\u2010term efficacy and potential adverse effects of these alternatives is mandatory. \u00a9 2006 Movement Disorder Society<\/jats:p>","DOI":"10.1002\/mds.20815","type":"journal-article","created":{"date-parts":[[2006,3,1]],"date-time":"2006-03-01T16:50:57Z","timestamp":1141231857000},"page":"816-823","source":"Crossref","is-referenced-by-count":97,"title":["Incomplete emptying and urinary retention in multiple\u2010system atrophy: When does it occur and how do we manage 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