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Lower urinary tract dysfunctions in patients with spinal cord tumors
Author(s) -
Uchiyama Tomoyuki,
Sakakibara Ryuji,
Hattori Takamichi,
Yamanishi Tomonori
Publication year - 2003
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.10070
Subject(s) - medicine , conus medullaris , cauda equina , dyssynergia , spinal cord , lumbosacral joint , urinary system , lumbar , urinary retention , spinal cord neoplasm , urinary bladder , detrusor muscle , syringomyelia , cauda equina syndrome , urology , surgery , psychiatry
Aims The objective of this study was to elucidate the incidence and pathophysiology of lower urinary tract dysfunctions (LUTS) in patients with spinal cord tumors. Methods Urinary questionnaire and urodynamic studies were done in 76 patients with spinal cord tumors. Results The patients included 56 with cervical‐thoracic (C1 to T11) and 20 with lumbosacral tumors. The lumbosacral tumors consisted of 12 epiconus/conus medullaris (below T11) and 8 cauda equina tumors. These tumors were further subdivided into intramedullary, intradural extramedullary, and dumbbell‐type. More than 83% of the patients had urinary symptoms. Patients with cervical‐thoracic tumors commonly had voiding symptoms (75%). Detrusor hyperreflexia (39%), and detrusor areflexia on voiding (21%) were the main urodynamic features. Patients with epiconus/conus medullaris tumors commonly had voiding symptoms as well (58%), but decreased urge to void (50%), detrusor‐sphincter dyssynergia (42%), and detrusor areflexia on voiding (32%) were the main features. Patients with cauda equina tumors commonly had storage symptoms (88%), of which sensory urgency was most common (63%). Severe LUTS occurred in the epiconus/conus medullaris tumors and in the intramedullary tumors. These dysfunctions tended to appear late and rarely appeared as the initial symptom in the course of the disease. There was no significant relationship between neurologic abnormalities and LUTS. Urodynamics showed that spinal cord tumors cause a variety of LUTS, depending on the location and the type of the tumor. Conclusion Spinal cord tumors are commonly accompanied by LUTS. Clinical and urodynamic evaluation is crucial to diagnosis and management since there is little relationship between symptoms and findings. Neurourol. Urodynam. 23:68–75, 2004. © 2003 Wiley‐Liss, Inc.