Urodynamic Studies in Patients With Intervertebral Prolapse

Abstract

Thirty-one patients with intervertebral disc prolapse (IDP) underwent urodynamic study before surgical operation. The lesion was located between C4 and T10 in 14, T11 and L2 in 2 and L2 and S1 in 15 patients. Preoperative urinary symptoms were obstructive in 11 (36%), irritative in 5 (16%) and both obstructive and irritative in 5 (16%) patients, and the remaining 19 patients (32%) had no symptoms. Preoperative urodynamic abnormalities were noted in 23 cases (74%): abnormal urinary uroflow in 6 of 14 cases (43%), residual urine of more than 30 ml in 9 of 31 cases (29%), abnormal cystometrogram and/or external sphincter EMG in 16 of 31 cases (52%). These urodynamic abnormalities were closely correlated with perineal hyposensitivity. Voiding function was re-examined in 22 patients after operation: improved in 14 (64%), unchanged in 1 (4%), worsened in 2 (9%) and normal in 5 (23%) before and after operation. Therefore the above results could indicate that the presence of perineal hyposensitivity should be suspected to have voiding dysfunction in patients with IDP. Orthopedic surgery may improve voiding dysfunction in the majority of patients.