摘要
Background: The micturition reflex is under the tonic influence of suprapontin e structures including the anteromedial frontal cortex, basal ganglia, and hypot halamus. However, there have been few reports about the role of the hypothalamus on the lower urinary tract (LUT) function in humans. Objective: To investigate LUT function in patients with pituitary adenomas.Methods: Urodynamic studies wer e carried out in three patients with LUT symptoms who had pituitary adenomas ext ending upwards to the hypothalamus. Results: All three male patients(age 28 to 6 2 years) developed LUT symptoms (urinary urgency and frequency (3); urinary inco ntinence (3); voiding difficulty and retention (2)) along with weight loss, psyc hiatric symptoms,unsteady gait, and/or visual disturbances. One had the syndrome of inappropriate secretion of antidiuretic hormone,but none had diabetes insipi dus. Two had resection of the tumour and subsequent radiation therapy, but LUT d ysfunction persisted. The third patient had partial resection of the tumour to a meliorate hydrocephalus. Urodynamic studies showed detrusorover activity during the storage phase in all patients; during the voiding phase there was underactiv e detrusor in two andnon-relaxing sphincter in one. Conclusions: Hypothalamic l esions can cause severe LUT dysfunction in both the storage and voiding phases o f micturition. This may reflect the crucial role of the hypothalamus in regulati ng micturition in humans.
Background: The micturition reflex is under the tonic influence of suprapontin e structures including the anteromedial frontal cortex, basal ganglia, and hypot halamus. However, there have been few reports about the role of the hypothalamus on the lower urinary tract (LUT) function in humans. Objective: To investigate LUT function in patients with pituitary adenomas.Methods: Urodynamic studies wer e carried out in three patients with LUT symptoms who had pituitary adenomas ext ending upwards to the hypothalamus. Results: All three male patients(age 28 to 6 2 years) developed LUT symptoms (urinary urgency and frequency (3); urinary inco ntinence (3); voiding difficulty and retention (2)) along with weight loss, psyc hiatric symptoms,unsteady gait, and/or visual disturbances. One had the syndrome of inappropriate secretion of antidiuretic hormone,but none had diabetes insipi dus. Two had resection of the tumour and subsequent radiation therapy, but LUT d ysfunction persisted. The third patient had partial resection of the tumour to a meliorate hydrocephalus. Urodynamic studies showed detrusorover activity during the storage phase in all patients; during the voiding phase there was underactiv e detrusor in two andnon-relaxing sphincter in one. Conclusions: Hypothalamic l esions can cause severe LUT dysfunction in both the storage and voiding phases o f micturition. This may reflect the crucial role of the hypothalamus in regulati ng micturition in humans.
出处
《世界核心医学期刊文摘（神经病学分册）》
2005年第7期25-25,共1页
Digest of the World Core Medical Journals:Clinical Neurology
