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[Continuing neurologic assessment in myelodysplasia]
M A Rapariz González1, J Salinas Casado, J A Belón-López Tomasetti
1Servicio de Urología, Hospital Universitario Nuestra Señora del Pino, Universidad de Las Palmas de Gran Canaria, España.
Objectives:
Myelodysplasia produces a neurological lesion with unpredictable urodynamic sequelae. The present study describes our experience in 18 patients with myelodysplasia and vesicourethral dysfunction.
Methods:
The study comprised 18 patients (11 males and 7 females) with myelodysplasia and vesicourethral dysfunction. Patient median age was 15.7 years (range 7 months-57 years) and the mean follow-up was 20 months (range 7-47 months). After physical and neurological examination, all patients underwent a complete urodynamic evaluation, including selective electromyography of the periurethral sphincter and videocystography. The urodynamic studies were repeated regularly during follow-up.
Results:
14 patients (67.7%) showed a lower motor neuron vesicourethral dysfunction; 2 (11.1%) had upper motor neuron lesion and 2 (11.1%) mixed motor neuron lesion. During the study period, no alterations were observed in the urodynamic pattern of patients with upper or mixed motor neuron lesions, but 9 patients (64.2%) with lower motor neuron lesions showed changes in the urodynamic pattern compared with the first evaluation, with alterations in bladder compliance being the most frequent.
Conclusions:
Alterations in bladder compliance may arise from neurogenic and nonneurogenic factors. Our findings indicate the need for close urodynamic surveillance of patients with myelodysplasia and vesicourethral dysfunction.