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Micturitional disturbance in syringomyelia
R Sakakibara1, T Hattori, K Yasuda
1Department of Neurology, Kashima Rosai Hospital, Japan.
Journal of the Neurological Sciences
|November 1, 1996
Summary
Syringomyelia frequently causes urinary dysfunction due to nerve damage. Treatments like shunts and alpha-blockers show promise in improving these symptoms.
Area of Science:
- Neurology
- Urology
Background:
- Syringomyelia, a condition causing fluid-filled cavities in the spinal cord, can lead to significant neurological deficits.
- Urinary dysfunction is a common but often underreported complication of syringomyelia.
Purpose of the Study:
- To investigate the prevalence and urodynamic characteristics of urinary symptoms in patients with syringomyelia.
- To explore potential therapeutic interventions for managing micturitional disturbances in this patient population.
Main Methods:
- Micturitional histories and urodynamic studies were conducted on 14 patients diagnosed with syringomyelia.
- Analysis included voiding difficulties, urinary retention, frequency, incontinence, and urgency.
- External sphincter muscle activity was assessed via motor unit potential analysis.
Main Results:
- Eleven of 14 patients (79%) reported urinary symptoms, with voiding difficulty being most common (8 patients).
- Urodynamic findings included detrusor hyperreflexia (7 patients), detrusor areflexia (4 patients), and detrusor-sphincter dyssynergia (4 patients).
- Neurogenic changes in the external sphincter were observed in 5 of 6 patients evaluated.
Conclusions:
- Syringomyelia frequently causes diverse urinary symptoms, often appearing years after initial neurological deficits.
- Both supranuclear and nuclear nerve dysfunctions contribute to micturitional disturbances.
- Syringosubarachnoid shunts and alpha-adrenoreceptor blocking agents demonstrated potential for symptom improvement.