Téma: 

Multiple sclerosis and the urologist

Marek Vargovčák, Ladislav Valanský, Nora Klímová

Cieľ práce: V práci prezentujeme aktuálny prehľad urologického prístupu k pacientom so sklerózou multiplex (SM), so zameraním na patológiu a patofyziológiu vplyvu na močovo-pohlavné ústrojenstvo, diagnostický postup a liečbu neurologických a urologických symptómov. Prezentujeme tiež vlastné klinické pozorovania v skupine 31 pacientov so SM vyšetrených od septembra 2004 do júna 2006. Materiál a metódy: Aktuálne práce so zameraním na neurologické a urologické prejavy SM, ako aj práce zamerané na diagnostiku a liečbu ochorenia boli vyhľadané pomocou MEDLINE databázy. Následne bolo analyzovaných 31 urodynamických nálezov a vyšetrení u pacientov s evidentne diagnostikovanou SM. Výsledky: Symptómy močových ciest u SM pacientov siahajú od urgencií, urgentnej inkontinencie až po retenciu moču. Symptómy neodrážajú patologické zmeny na močových cestách, ale paralelnú dysfunkciu pyramídových dráh. Urodynamické vyšetrenie zohráva významnú úlohu v hodnotení manažmentu močového mechúra. Najčastejším urodynamickým nálezom je detrúzorová hyperaktivita u 74 % pacientov v našom súbore. Nasleduje detrúzoro-sfinkterická dyssynergia u 13 % a detrúzorová hypo až areflexia u 13 % pacientov. Menej ako 1 % pacientov má poškodené renálne funkcie a väčšina môže byť liečená konzervatívnymi metódami. V prípade zlyhania konzervatívnej liečby môže byť efektívnou chirurgická liečba. Incidencia sexuálnej dysfunkcie je 80 % u mužov a 72 % u žien. Liečba je zameraná na zlepšenie celkového stavu pacientov a navodenie erektilnej alebo orgazmickej funkcie. Záver: Napriek tomu, že močovo-pohlavné príznaky u SM pacientov sú zriedkavo život ohrozujúce, spôsobujú signifikantnú morbiditu a frustráciu pacientov. Urológ preto musí byť aktívne zapojený do multidisciplinárnej liečby týchto pacientov.
Kľúčové slová: skleróza multiplex, urodynamické vyšetrenie, močový mechúr, neurogénny

Ročník 2007  Témy časopisu Clinical urology 1 / 2007

CHAIRMAN OF THE EDITORIAL BOARD
prof. MUDr. Ján Kliment, CSc.

MEMBERS OF THE EDITORIAL BOARD
prof. Andrzej Borówka, M.D., PhD.
prof. MUDr. Ján Breza, DrSc.
prof. MUDr. Peter Bujdák, PhD.
prof. MUDr. Tomáš Hanuš, DrSc.
doc. MUDr. Ladislav Jarolím, CSc.
doc. MUDr. Ján Ľupták, PhD.
doc. MUDr. Jozef Marenčák, PhD.
doc. MUDr. Ivan Minčík, PhD.
prof. MUDr. Dalibor Ondruš, DrSc.
prof. Imre Romics, M.D., PhD.
doc. MUDr. Vladimír Študent, PhD.
prof. MUDr. Ján Švihra, PhD.
prof. MUDr. Ladislav Valanský, PhD.
doc. MUDr. František Záťura, PhD.
MUDr. Peter Zvara, PhD.

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prof. MUDr. Ján Švihra, PhD.

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2. Stenestrand U, Wallentin L. Swedish Register of Cardiac Intensive Care (RIKS-HIA): Early statin treatment following acute myocardial infarction and 1-year survival. JAMA 2001; 285: 430-436.
3. LIPID Study Group. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med 1998; 339: 1349-1357.
4. Jurkovičová O, Spitzerová H, Cagáň S. Komorové arytmie a náhla srdcová smrť pri akútnom infarkte myokardu. Bratisl Lek Listy 1997; 98: 379-389.
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Which of following factors is not related to rosacea?
a. genetic predisposition
b. Scandinavian origin
c. propionibacterium acnes
d. endothelial growth factor

The editorial board reserves the right to make small stylistic changes in the paper. If it is necessary to shorten the paper, the consent of the author will be required. All articles are reviewed.

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