Urinary disorders in intervertebral disc prolapse

Abstract

Ncurogenic bladder caused by intervertebral disc prolapse (IDP) is a well-known condition, affecting up to 18% of patients with IDP. We present our results after studying 82 patients, 67 of whom were fully evaluated from a neurourological point of view. Neurological and urological symptoms persisted long after the neurosurgical operation had been performed. The most common finding was that of a normal-compliance areflexic bladder associated with normal or incomplete denervation of perineal floor muscles. This pattern may be explained either by incomplete damage of the motor visceral (preganglionic, parasympathetic) fibers or by a pure sensory lesion. This explanation is confirmed by the significantly reduced positivity of the betanechol test in these cases compared to the 100% positivity results obtained in cases of low-compliance areflexic bladder.

Interrelationships of bladder compliance with age, detrusor instability, and obstruction in elderly men with lower urinary tract symptoms

“…Although the clinical relevance of BC in patients with meningomyelocele, spinal cord injury, intervertebral disc prolapse, and peripheral nerve injury after pelvic surgery has been studied in detail, little is known about the interrelationships of BC with benign prostatic enlargement (BPE), BOO, and DI in elderly men with LUTS [Speakman et al, 1987;Sandri et al, 1987;Gotoh et al, 1991;Shiina et al, 1993;Fig. 1.…”

Urodynamic evaluation of surgical outcome in patients with urinary retention due to central lumbar disc prolapse

“…Urinary disorders usually follow or accompany more obvious neurologic symptoms that allow a proper diagnosis to be made. But sometimes voiding disturbances may be the only or the ¢rst symptom of central lumbar disc prolapse, and the diagnosis of cauda equina compression becomes more di⁄cult [Robinson, 1965;Sandri et al, 1987;O'Flynn et al, 1992;Nesathurai and Jessiman, 1999]. One of our patients (Pt.…”

“…Although the recovery of voiding function after central disc prolapse has been reported to be uncommon and most patients are left with an acontractile detrusor [Scott, 1965;Andersen and Bradley, 1976;Brooks et al, 1985;Sandri et al, 1987;O'Flynn et al, 1992;Bartolin et al, 1999], some reports have obtained good results after surgery for lumbar disc prolapse [Rosomo¡ et al, 1970;Emmett and Love, 1971;Ross and Jameson, 1971;Jones and Moore, 1973;Sharr et al, 1976;Susset et al, 1982], arachnoiditis, epidural ¢brosis, or axonal ischemia have been considered to be the reason for poor postoperative outcomes [Bartolin et al, 1999;Wagner, 1999].…”

“…Incomplete denervation is evidenced by the association of normal motor unit potentials with denervation potentials (such as positive sharp waves), reduced recruitment patterns and long-lasting polyphasic potentials owing to reinnervation. A denervated pattern is characterized by silent electromyograms with eventual ¢brillation potentials and/or positive sharp waves [Sandri et al, 1987;Sakakibara et al, 2001a,b]. Methods, de¢nitions, and units conform to the standards recommended by the International Continence Society, except where speci¢cally noted [St˛hrer et al, 1999;Abrams et al, 2002].…”