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Micturitional disturbance in radiation myelopathy
R Sakakibara1, T Hattori, M Tojo
1Department of Neurology, School of Medicine, Chiba University, Japan.
Journal of Spinal Disorders
|October 1, 1993
Summary
Radiation myelopathy frequently causes severe urinary dysfunction, affecting both bladder storage and emptying. Treatment combining steroid pulse therapy and hyperbaric oxygen showed promise in improving these symptoms.
Area of Science:
- Neurology
- Urology
Background:
- Radiation myelopathy can lead to significant neurological deficits.
- Lower urinary tract dysfunction is a potential complication of radiation therapy to the pelvis.
Purpose of the Study:
- To investigate the micturitional symptoms and urodynamic findings in patients with radiation myelopathy.
- To explore potential therapeutic interventions for radiation-induced bladder dysfunction.
Main Methods:
- Detailed micturitional histories and urodynamic studies were conducted in five patients.
- Evaluations included cystometry and external sphincter electromyography.
- Therapeutic outcomes were assessed in patients receiving steroid pulse therapy and hyperbaric oxygen therapy.
Main Results:
- All five patients presented with micturitional symptoms, including irritative (5/5) and obstructive (4/5) patterns.
- Four patients experienced urinary incontinence.
- Urodynamic studies revealed detrusor hyperreflexia (4/5), detrusor-sphincter dyssynergia (4/5), and significant residual urine (average 158 ml in 3/5 patients).
Conclusions:
- Micturitional disturbances are common and severe in radiation myelopathy, impacting both storage and evacuation.
- Lesions in supranuclear parasympathetic and somatic nervous systems appear responsible for lower urinary tract dysfunction.
- Combination therapy of steroid pulse and hyperbaric oxygen showed potential for improving urinary symptoms and neurological deficits.