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Chronic urinary retention--a sensory problem?

B T Parys¹, D G Machin, K A Woolfenden

¹Clinical Department of Urology, Royal Liverpool Hospital.

British Journal of Urology

|December 1, 1988

Summary

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Benign prostatic hyperplasia can lead to chronic urinary retention due to an occult neuropathy affecting higher neurological centers. This study found sensory abnormalities in men with chronic retention, suggesting an adaptive mechanism to bladder outflow obstruction.

Area of Science:

Urology
Neuroscience
Physiology

Background:

Benign prostatic hyperplasia (BPH) is a common condition in aging men.
The factors predisposing to chronic versus acute urinary retention in BPH are not fully understood.
Occult neuropathy may play a role in the development of chronic urinary retention.

Purpose of the Study:

To investigate the integrity of the lower urinary tract nerve supply in men with chronic urinary retention secondary to BPH.
To determine if neurophysiological abnormalities are associated with chronic urinary retention in BPH patients.

Main Methods:

Sacral reflex latency measurements were performed on 22 male patients with chronic urinary retention due to BPH.
Neurophysiological testing assessed the nerve supply to the lower urinary tract.

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Main Results:

73% of patients demonstrated a sensory suprasacral abnormality.
Spinal reflex arcs remained intact in the affected patients.
Findings suggest a sensory/proprioceptive abnormality in higher neurological centers.

Conclusions:

The intact sacral reflex pathways indicate that the abnormality is not at the spinal level.
A sensory/proprioceptive deficit in higher neurological centers may be an adaptive response to bladder outflow obstruction in BPH.
This finding sheds light on the pathophysiology of chronic urinary retention in BPH.