Micturitional Disturbance in a Patient with Adrenomyeloneuropathy

This case study reported on a patient with adrenomyeloneuropathy (AMN) who developed neurogenic bladder dysfunction, characterized by urinary urgency, difficulty voiding, and other neurological symptoms. The patient began losing hair at age 12 and experienced progressive symptoms, including erectile impotence and gait disturbance, by age 25. By age 31, he exhibited spastic paraparesis and disturbed vibratory sensation, with diagnostic tests confirming AMN through low serum cortisol response and increased very long chain fatty acids. Urodynamic studies revealed impaired bladder function, with residual urine volumes increasing from 50 ml to 200 ml over time, alongside decreased bladder capacity and marked detrusor hyperreflexia. The study suggested that demyelinating lesions in the peripheral nerves and central nervous system contributed to the micturitional disturbances observed in this patient.