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Bladder dysfunction in patients with cauda equina lesions.

Simon Podnar1, Bojan Trsinar, David B Vodusek

  • 1Institute of Clinical Neurophysiology, Division of Neurology, University Medical Center Ljubljana, Ljubljana, Slovenia. simon.podnar@kclj.si

Neurourology and Urodynamics
|October 15, 2005
PubMed
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Lower urinary tract dysfunction is common in patients with cauda equina lesions, significantly impacting daily and sexual life. Regular cystometric surveillance is recommended due to poor symptom-finding correlation.

Area of Science:

  • Urology
  • Neurology
  • Rehabilitation Medicine

Background:

  • Data on lower urinary tract (LUT) function in patients with cauda equina lesions are limited.
  • Chronic cauda equina lesions often lead to significant neurological deficits affecting bodily functions.

Purpose of the Study:

  • To systematically assess lower urinary tract (LUT) function in a cohort of 65 patients with chronic cauda equina lesions.
  • To characterize the prevalence and severity of urinary dysfunction and its impact on quality of life.

Main Methods:

  • Utilized a urinary function questionnaire and performed neurological examinations.
  • Conducted quantitative electromyography (EMG) of external anal sphincter (EAS) muscles and sacral reflex assessment.
  • Performed conventional urodynamic measurements, including filling and voiding cystometry.

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Main Results:

  • High prevalence of severe (14-15%) and moderate (27-46%) LUT dysfunction was observed.
  • Urinary symptoms affected daily life in 88-92% and sexual life in 67-72% of patients.
  • Abnormalities were common in perianal sensation (96%), EAS EMG (88%), sacral reflex (84%), and postvoid residual volumes (40-17%).

Conclusions:

  • Significant LUT dysfunction is prevalent in patients with chronic cauda equina lesions, substantially impacting their quality of life.
  • A poor correlation exists between patient-reported symptoms and urodynamic findings.
  • Recommends cystometric surveillance for all patients with significant cauda equina lesions to ensure optimal management.