Neurogenic lower urinary tract dysfunction in association with severity of degenerative spinal diseases: Short-term outcomes of decompression surgery

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms Pub Date : 2022-05-10 DOI:10.1111/luts.12444

Shingo Kimura, Shunichi Takyu, Naoki Kawamorita, Takashige Namima, Naoki Morozumi, Akihiro Ito

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引用次数: 1

Abstract

Objectives

Cervical myelopathy (CM) and lumbar canal stenosis (LCS) are common degenerative spinal diseases among the elderly, and the major associated complaints include lower urinary tract symptoms (LUTS). The aim of this study was to investigate subjective and objective urological parameters of patients undergoing decompression surgery for CM and LCS.

Methods

We retrospectively reviewed patients who underwent evaluation by the International Prostate Symptom Score (IPSS) and uroflowmetry before decompression surgery for CM and LCS. Patients with comorbidities that can affect LUTS were excluded. Postoperative changes were evaluated in patients followed up within 1 month.

Results

Among referrals to urological consultations for LUTS, 231 patients were evaluated preoperatively. Moderate-severe urinary symptoms (IPSS ≥ 8) were present in 59.8% of 92 CM patients and 64.0% of 139 LCS patients. Poor voiding patterns defined as maximum urinary flow rate <12 mL/s or postvoid residual volume >100 mL were identified in 26.1% of CM and 25.2% of LCS. While IPSS did not associate with disease severity, poor voiders presented with worse Japanese Orthopedic Association scores. Moreover, poor voiders suffered for a longer period of time from orthopedic symptoms due to LCS. In followed-up patients (CM, n = 32; LCS, n = 47), total IPSS, storage subscores, and voiding subscores were significantly improved after surgery, as was voiding time from uroflowmetry.

Conclusions

This study demonstrated high prevalence of lower urinary tract dysfunction of CM and LCS as well as short-term effectiveness of decompression surgery. These results would encourage urologists to consider an orthopedic consultation when lower urinary tract dysfunction is identified in patients with degenerative spinal diseases.

查看原文本刊更多论文

神经源性下尿路功能障碍与退行性脊柱疾病严重程度的关系:减压手术的短期结果

目的颈椎病(CM)和腰椎管狭窄症(LCS)是老年人常见的退行性脊柱疾病，主要的相关症状包括下尿路症状(LUTS)。本研究的目的是探讨CM和LCS减压手术患者的主客观泌尿学参数。方法回顾性分析CM和LCS减压手术前接受国际前列腺症状评分(IPSS)和尿流测量评估的患者。排除了可能影响LUTS的合并症患者。术后1个月内随访观察患者术后变化。结果在LUTS泌尿科会诊的转诊患者中，231例患者术前接受了评估。92例CM患者中有59.8%出现中重度泌尿系统症状(IPSS≥8)，139例LCS患者中有64.0%出现中重度泌尿系统症状。26.1%的CM患者和25.2%的LCS患者存在排尿不良模式，定义为最大尿流量≤12 mL/s或排尿后残余容量≤100 mL。虽然IPSS与疾病严重程度无关，但较差的患者表现出较差的日本骨科协会评分。此外，由于LCS，贫穷的提供者遭受矫形症状的时间更长。随访患者(CM, n = 32;LCS (n = 47)、总IPSS、储存亚评分和排尿亚评分在手术后显著改善，尿流测量的排尿时间也显著改善。结论CM和LCS患者下尿路功能障碍发生率高，减压手术短期有效。这些结果将鼓励泌尿科医生考虑在退行性脊柱疾病患者中发现下尿路功能障碍时进行骨科会诊。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

LUTS: Lower Urinary Tract Symptoms UROLOGY & NEPHROLOGY-

CiteScore

3.00

自引率

7.70%

发文量

审稿时长

>12 weeks

期刊介绍： LUTS is designed for the timely communication of peer-reviewed studies which provides new clinical and basic science information to physicians and researchers in the field of neurourology, urodynamics and urogynecology. Contributions are reviewed and selected by a group of distinguished referees from around the world, some of whom constitute the journal''s Editorial Board. The journal covers both basic and clinical research on lower urinary tract dysfunctions (LUTD), such as overactive bladder (OAB), detrusor underactivity, benign prostatic hyperplasia (BPH), bladder outlet obstruction (BOO), urinary incontinence, pelvic organ prolapse (POP), painful bladder syndrome (PBS), as well as on other relevant conditions. Case reports are published only if new findings are provided. LUTS is an official journal of the Japanese Continence Society, the Korean Continence Society, and the Taiwanese Continence Society. Submission of papers from all countries are welcome. LUTS has been accepted into Science Citation Index Expanded (SCIE) with a 2011 Impact Factor.