This retrospective chart review evaluated lower urinary tract symptoms (LUTS) and urodynamic (UDS) findings in 27 adult patients with confirmed hypermobile Ehlers-Danlos Syndrome (hEDS) who underwent video urodynamics at a single tertiary-care center between 2022 and 2025.
LUTS were common: urinary frequency (74.1%), weak stream (51.8%), nocturia (48.1%), bladder pain (33.3%), recurrent UTIs (25.9%), and incontinence (14.8%). Urodynamics showed **no** detrusor overactivity, stress urinary incontinence, or compliance abnormalities; pelvic floor dysfunction (dyssynergic EMG during voiding) was found in 18.5% (n=5). Pelvic floor physical therapy was the most recommended treatment, followed by beta-3 agonists.
- Very small sample (n=27) from a single tertiary-care center limits generalizability. - Retrospective design introduces selection and ascertainment bias. - Cohort was 92.6% female and 92.6% white, limiting applicability to other demographics.
In hEDS patients with LUTS, urodynamics are unlikely to reveal intrinsic bladder pathology—pelvic floor dysfunction and neurologic contributors appear more relevant. Prioritize pelvic floor physical therapy evaluation before escalating to pharmacologic or invasive bladder-directed interventions.
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