Urological evaluation in the Shy Drager syndrome.

Nine patients with the Shy-Drager syndrome underwent complete urological and neurological investigation of bladder symptoms. Urodynamic studies revealed detrusor areflexia in 6 patients (67 per cent), detrusor hyperreflexia in 3 (33 per cent), a lower motor neuron lesion involving the periurethral striated muscle in 9 (100 per cent) and an open vesical neck at rest in all 5 patients in whom cystography was performed. These findings support the current view that parasympathetic, pudendal and sympathetic involvement is part of the pathophysiology of the Shy-Drager syndrome.