Urodynamic and electrophysiologic study of the urinary disturbances caused by cervical myelopathy

Urinary disturbance is one of the significant symptoms of cervical myelopathy. To make the diagnosis of urinary disturbance, preoperative urodynamic studies and evoked spinal cord potentials (ESCPs) recording were performed on 60 surgical patients with cervical myelopathy. Half (30) of this group complained of urinary disturbance, and 22 (37%) were diagnosed as having neurogenic bladder. The presence of neurogenic bladder was closely correlated with severe limb symptoms and relatively slow ESCP velocity. It was confirmed that neurogenic bladder was caused by severe spinal cord damage. However, for 47% of the patients with urinary complaints, findings of urodynamic examinations were negative; these patients probably had pathologic or psychosomatic factors other than neurogenic bladder due to cervical myelopathy. The prognosis of the neurogenic bladder appears to be influenced by irreversibility of the spinal cord lesions.