Urinary complaints and voiding function in patients operated for lumbar spinal stenosis

Degenerative lumbar spinal stenosis (LSS) is a condition with compression of the dural sac at one or more lumbar levels. Studies investigating whether LSS may affect the urinary function are scarce and have traditionally included few patients. The aim of this study was to examine voiding complaints and urinary function before and after surgery for LSS.

A total of 81 patients undergoing surgery for symptomatic LSS were prospectively enrolled between October 1, 2022, and July 31, 2024, of which 60 patients were included in the final analyses. Patients were evaluated by questionnaire (International Prostate Symptom Score, IPSS), urinary flow (Q_max, ml/s) and residual urinary bladder volume (RUV) (ultrasonographic measurement, ml) at pre- and post-operative controls.

36 patients were males, median age was 69.5 years. Median dural-sac cross sectional area (DSCA) was 41.7 mm² and 53/59 (89.8 %) patients had Schizas grade C or D indicating significant lumbar stenosis. Median pre-operative scores for urinary symptoms were IPSS 11.0, uroflowmetry 14.3 ml/s and RUV 59.5 ml. Post-operatively, median values of IPSS were 9.0, uroflowmetry 13.8 ml/s and RUV 69.0 ml. There were no statistically significant differences between pre- and post-operative results for neither men nor women. A pre-operative RUV > 100 ml was noted in 21/60 (35.0 %) patients.

Urinary complaints were common in this cohort of surgically treated lumbar spinal stenosis. Decompressive surgery did not significantly alter the results of IPSS, uroflowmetry or RUV. Approximately one third of the patients had a RUV > 100 ml pre-operatively.