Multiple System Atrophy with Neurogenic Incomplete Bladder Emptying and Elevated Post-Void Residual Volume
Multiple system atrophy can cause neurogenic incomplete bladder emptying. When the measured post-void residual volume exceeds 100 mL, this represents a clinically significant urological complication that calls for a structured, evidence-based management approach.
Clinical Scenario
This protocol targets patients with Multiple system atrophy presenting with neurogenic incomplete bladder emptying and a post-void residual volume greater than 100 mL. This threshold identifies a distinct pattern of urological dysfunction in MSA that shapes the choice and sequencing of interventions.
Management Approach
In patients with severe disease and significant disability, the protocol may call for a permanent urinary drainage solution. The full structured regimen — covering precise indications, clinical thresholds, and the complete decision pathway — is accessible via the link below.
References
DOI: 10.1212/cont.0000000000001598
- Neurogenic incomplete bladder emptying can be improved with α-adrenergic blockers that act on the urethra (such as tamsulosin or prazosin); however, they can worsen orthostatic hypotension.
- Clean intermittent self-catheterization may be recommended in patients with a postvoid residual volume of greater than 100 mL.
- A permanent catheter (ie, suprapubic canular drainage) may be required in patients with severe disease and disability.