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Nonneuropathic Neuropathic Bladder-Is it Really Nonneuropathic?
Sibel Tiryaki1, Cenk Eraslan2, Tutku Soyer3
1Department of Pediatric Surgery, Division of Pediatric Urology, Ege University , Izmir , Turkey.
The Journal of Urology
|September 25, 2018
Summary
Diffusion tensor imaging revealed abnormal findings in the lumbosacral plexus of patients with Hinman syndrome, suggesting a potential neuropathic etiology for this rare bladder dysfunction. This study offers new insights into the condition's origins.
Area of Science:
- Neurology
- Urology
- Radiology
Background:
- Hinman syndrome presents with bladder dysfunction mimicking neuropathic bladder but lacks a known neuropathic cause.
- Diffusion tensor imaging (DTI) is an advanced MRI technique for evaluating peripheral nerves and the lumbosacral plexus.
Purpose of the Study:
- To investigate the lumbosacral plexus in patients with Hinman syndrome using DTI.
- To explore a potential neuropathic etiology for Hinman syndrome.
Main Methods:
- 12 patients with Hinman syndrome and 12 controls underwent DTI of the lumbosacral plexus on a 3.0 Tesla MRI system.
- Tractography, fractional anisotropy (FA), and mean diffusivity (MD) were used to analyze nerve integrity.
- FA and MD values were compared between patients and controls.
Main Results:
- Patients with Hinman syndrome showed significantly higher mean diffusivity (1.39) compared to controls (1.28) in the lumbosacral plexus (p < 0.001).
- Fractional anisotropy values were similar between patients and controls, suggesting specific microstructural changes.
Conclusions:
- DTI revealed abnormal lumbosacral plexus findings in Hinman syndrome patients, consistent with nerve injury.
- This study provides the first evidence suggesting Hinman syndrome may stem from a neuropathic origin.
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