Disorders of Micturition in Tabes Dorsalis

Abstract

The aim of this study was to determine whether the disorders of micturition that occur in patients with tabes dorsalis can be attributed exclusively to disturbed bladder sensation, as has been previously suggested. Urodynamic studies were performed in 8 patients with tabes dorsalis who had no obvious organic obstructive urological disease. The results indicated that not only disturbed bladder sensation but also suprasacral and/or sacral lesions innervating the detrusor could be responsible for voiding dysfunction in such patients.

Effect of Injury to the Dorsal Funiculus of the Thoracic Spinal Cord on Micturition in Decerebrate and Freely-Moving Cats

“…We found that dorsal funiculus transection resulted in a significant decrease of voided weight in all freely-moving cats and transient sensory reflex incontinence in one. Thus, the cerebral cortex alone could not control the micturition reflex completely without any information transmitted via the dorsal system, although our present data were not consistent with the clinical data reported by Hattori et al [15].…”

“…Vesicosensory pathways have been reported in the dorsal funiculus [13] or in the region anterior to the equatorial line of the spinal cord [14]. Hattori et al [15] stated that bladder sensation was often compromised in the tabes dorsalis, which mainly affects the dorsal funiculus of the spinal cord. Bladder sensation is preserved, but not completely intact, in patients with the anterior spinal artery syndrome, which affects the anterior two-thirds of the thoracolumbar cord, suggesting that some bladder sensation may travel via the dorsal funiculus [16].…”

Bladder dysfunction in subacute combined degeneration

“…Lack of bladder sensation until 437 ml, lack of urge to void and absence of detrusor contraction have been reported in a patient with SACD [6]. Detrusor areflexia has been reported in spinal shock following spinal cord injury and acute transverse myelitis [11]. In SACD, however the clinical course is subacute or chronic and the possibility of spinal shock is unlikely.…”

What are the causes and consequences of bladder overdistension?: ICI‐RS 2011

“…In the majority of cases, chronic overdistension presents as a symptom of diabetes mellitus (DM) 39. It may also be associated with lesions or injury to the nerves that innervate the bladder,40 for example, lumbrosacral lesions in multiple sclerosis41 and suprasacral and/or sacral lesions in tabes dorsalis 42. Prolonged bladder overdistension in patients with urinary retention secondary to the bladder outlet obstruction appears to be rare, presumably because the obstruction is treated before overdistension occurs, or the bladder becomes overdistended over a prolonged period of time.…”