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Low back pain and urinary incontinence. A hypothetical relationship
S M Eisenstein1, D J Engelbrecht, W S el Masry
1Centre for Spinal Studies, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire, United Kingdom.
Spine
|May 15, 1994
Summary
Severe low back pain may be linked to urinary incontinence. Successful back pain treatment often resolves incontinence, suggesting a connection beyond typical neurological or genitourinary causes.
Area of Science:
- Neurology
- Urology
- Spinal Surgery
Background:
- A spinal practice observed an association between low back pain and urgency urinary incontinence in 16 out of 5000 new patients over 5 years.
- The incontinence was severe enough to cause daily distress and disruption, prompting further investigation.
Purpose of the Study:
- To highlight the unusual association of low back pain with urinary incontinence.
- To prompt clinicians to investigate potential neurologic mechanisms for this phenomenon.
Main Methods:
- Patients underwent investigations including plain radiography, neurologic examination, lumbar spine imaging (myelography or CT), urine culture, and urodynamic studies.
- Surgical interventions for low back pain included spinal fusion and total hip replacement.
Main Results:
- Successful surgical treatment for low back pain (11 of 12 patients) led to cure or improvement of urgency incontinence.
- In patients with persistent back pain or awaiting surgery, urinary symptoms remained unchanged.
- Investigations did not reveal conventional neurologic or genito-urinary pathology.
Conclusions:
- A rare association exists between severe low back pain and urgency urinary incontinence.
- This condition is not explained by conventional neurologic or genito-urinary pathology and warrants clinical recognition.