[Disorders of micturition following intervertebral disk operations. Neurologic diagnosis and therapy]

Urodynamic investigation was carried out in 33 patients (14 male, 19 female) who presented with micturition disorders after prolapsed disc operation. The predominant symptom was urinary incontinence in 16 cases and urinary retention or residual urine in 17 cases; faecal incontinence was encountered in 15 patients. The main nerve supply for detrusor and sphincter muscles stems from the S-3 segment. Of 25 patients with unilateral or bilateral loss of sensation in the S-3 dermatome, 21 patients demonstrated detrusor areflexia, 11 of those with urinary incontinence, 10 with urinary retention and 13 with faecal incontinence. 4 patients showed normoreflexia of the detrusor, although three of them had urinary incontinence, one urinary retention and two faecal incontinence. The success of medication or electrostimulation is demonstrated in 17 patients on follow-up over a period of 12 months postoperatively. Medication alone was successful only when no peripheral nerve lesion was present. Out of 9 patients with a nerve lesion located at S-1/S-3, transurethral electrostimulation according to Katona was successful in two cases, whilst functional electrostimulation successful in another two cases.