Neurogenic bladder: a complication after endoscopic adhesiolysis with return of bladder function while using...

Area of Science:

• Neurosurgery
• Urology

Background:

• A 73-year-old woman with chronic low back pain and prior lumbar fusions presented with escalating pain.
• Previous treatments including interventions, physical therapy, and oral analgesics provided limited relief.

Observation:

• The patient underwent endoscopic lysis of adhesions for severe epidural scarring, leading to neurogenic bladder and urinary retention.
• Resolution of neurogenic bladder symptoms occurred three years later, coinciding with nitrofurantoin use.

Findings:

• Discontinuation of nitrofurantoin resulted in the inability to void spontaneously.
• Reinstitution of nitrofurantoin restored spontaneous voiding, with sustained efficacy for over three years.

Implications:

• This case suggests a potential therapeutic role for nitrofurantoin in managing neurogenic bladder, particularly in patients with spinal conditions.
• Further investigation is warranted to elucidate the mechanism and confirm the efficacy of nitrofurantoin for neurogenic bladder.
• This finding may offer a novel treatment avenue for patients suffering from neurogenic bladder and related voiding dysfunction.