Adult Manifestation of Lower Urinary Tract Dysfunction as Daytime Urinary Incontinence and Nocturnal Enuresis in a Case With Spinal Lipoma

Abstract

Introduction

Generally, lower urinary tract function is considered to show few changes in adulthood for cases of spina bifida.

Case Presentation

The case involved a 33-year-old man with a primary diagnosis of spinal lipoma. Urological management by spontaneous voiding was maintained, and uroflowmetry at 23 years old showed a maximum flow rate of 9.6 mL/s and a residual urine volume of 35 mL; then urological follow-up was ended. The patient developed nocturnal enuresis and daytime urinary incontinence. Residual urine was exceeding 500 mL. Bladder deformity was identified on VCUG. UDS showed a high storage pressure with compliance of 5.0 mL/cmH₂O. CIC management was introduced, and vibegron was initiated. After that, the urinary symptoms were resolved immediately. On video-UDS, bladder deformity and compliance had improved.

Conclusion

Patients managed by spontaneous voiding should be carefully evaluated for atypical UDS findings to decide whether urological follow-up can be considered complete.