Early detection of neurogenic bladder dysfunction caused by protruded lumbar disk

Area of Science:

• Neurology
• Urology
• Neurosurgery

Background:

• Cauda equina compression can manifest with urinary dysfunction.
• Early diagnosis is crucial for effective management and preventing permanent neurological deficits.

Observation:

• A patient presented with urinary symptoms suggestive of cauda equina compression.
• Diagnostic evaluation included rapid cystometry and sacral evoked response testing.

Findings:

• Type A contraction on rapid cystometry and prolonged sacral evoked response latency indicated cauda equina compression.
• Myelography confirmed the diagnosis, necessitating surgical intervention.
• Lumbar laminectomy successfully decompressed the cauda equina by removing a ruptured intervertebral disk.

Implications:

• Surgical decompression of the cauda equina effectively resolves urinary symptoms and restores normal bladder function.
• Normal cystometry and perineal muscle electromyography post-surgery confirm successful treatment.
• This case highlights the importance of integrating urodynamic and neurophysiological assessments in diagnosing cauda equina syndrome.