Abstract: ObjectiveTo recognize the features of genitourinary dysfunction in multiple system atrophy (MSA) and the importance of videourodynamics.Methods5 cases of MSA were reviewed.ResultsGenitourinary dysfunction in MSA included voiding problem, nocturnal urinary frequency, urgency, impotence and so on. The characteristic appearance of videourodynamics was that postvoiding volume more than 100 ml, detrusor-external sphincter dyssynergia (DESD) and open bladder neck at the start of bladder filling. The abnormal sphincter electromyography comprised of abnormal spontaneous activity, motor unit potentials (MUPs) more than 13 ms, polyphasic potentials more than 60%. MRI showed brain atrophy and the "hot cross bun" signal in the pontocerebellar degeneration.ConclusionMSA is a disorder characterized by progressive neuronal atrophy at certain sites of the central nervous system that control the urogenital function. MSA-related urological symptoms are analogous with symptoms of bladder outlet obstruction. It is necessary to take some reasonable investigations for avoiding misdiagnosis and unnecessary surgery.

Key words: multiple system atrophy, genitourinary dysfunction, videourodynamics