Lower Urinary Tract Symptoms in Systemic Sclerosis
Lower Urinary Tract Symptoms in Systemic Sclerosis
Urinary symptoms must be frequent in Scleroderma. In one hand, mobility limitation by joint
 stiffness and skin sclerosis, forced diuresis due to heart involvement (cardiomyopathy or
 pulmonary hypertension), diuretics use and corticoid-induced hyperglycaemia, as well as
 narcotic medication use, puts patients at higher risk of secondary bladder filling and
 voiding dysfunction. In another hand, few case report and small sample observational studies
 have identified a specific sclerosis of the urinary tract. Those two mechanisms must be more
 frequent in the diffuse cutaneous form of scleroderma (dcSSc) compare to the limited one
 (lcSSc). But prevalence or incidence is unknown.

 Urinary symptoms are seldom reported by those suffering from them and are rarely part of a
 systemic evaluation. In a threatening disease, urinary symptoms assessment might seem to be
 of no priority. But LUTS have a real impact on many aspect of everyday living. Furthermore
 urinary tract involvement might predispose to urinary tract infection due to flow limitation
 and stagnation. Since it is an inner fibrosis it might be associated with a more aggressive
 form of disease conferring a greater loss of physical function, higher risk for hospital
 admission and death.

 Thus, identifying urinary symptoms would permit to address specific rehabilitation or
 medication therapy, in order to minimize the consequences of the bothersome symptoms and
 identify those subjects at higher risk of urinary infection, aggressive disease/loss of
 function or death.

 This study will also give basement to build an interventional study directed toward LUTS
 treatment in this population.

 In this prospective cohort we would like to:

 -  Compare the prevalence of lower urinary tract symptoms (LUTS) in diffuse and limited
 forms of systemic sclerosis.

 -  Determine the prevalence (at inclusion) and incidence (in a two years period) of LUTS
 among patients suffering from systemic sclerosis.

 -  Evaluate the impact of LUTS symptoms on Quality of life.

 -  Compare the discrimination ability of Cochin-hand score and HAQ score to predict
 incontinence in this population.

 -  Evaluate the association between LUTS symptoms, hospital admission rate, urinary tract
 infection, mortality and loss of autonomy.
Inclusion Criteria:

 Adult suffering from systemic sclerosis included in network of Brescia (I), Geneva (CH),
 Padova (I) and Paris (F).

 Exclusion Criteria:

 Those unable to understand the rules and implications of the study, end of life patients,
 the pregnant women and anuric patients