Bladder neuropathy in lumbar disc disease

Disturbances of bladder, function often occur in cases of sciatica due to intervertebral disc lesions, although other clinical signs of sacral root compression are absent. In 32 patients, operated upon because of lumbar disc diseases without cauda equina syndrome, micturition symptoms were registered, and bladder function was investigated. Intravesical pressure/volume relations (water cystometry) and simultaneous intravesical pressure/urinary flow relations (urodynamic examination) were recorded preoperatively together with anal sphincter surface EMG. In almost half of the patients cystometry revealed bladder hyposensibility (late first sensation), and a quarter voided mainly by straining (detrusor paresis). These findings were unrelated to the neurosurgical pathology. Pronounced micturition symptoms or abnormal preoperative urodynamic examinations indicated evaluation two months after lumbar disc operation. Two-thirds tended towards recovery, one third remained unchanged.