Micturitional Disturbance in a Patient with Adrenomyeloneuropathy

The document reported a case of adrenomyeloneuropathy (AMN) in which a patient experienced neurogenic bladder dysfunction, among other symptoms. The patient, who began losing hair at age 12, developed urinary urgency, difficulty voiding, fecal incontinence, erectile impotence, and gait disturbance by age 25. By age 31, he exhibited diffuse baldness, spastic paraparesis, and disturbed vibratory sensation, with diagnostic tests confirming AMN. Urodynamic studies revealed impaired bladder function, with residual urine volume 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 nerve and white matter of the spinal cord and cerebrum were primarily responsible for the micturitional disturbances observed in this patient.