Micturition is a complex neurophysiological function based upon the correct function of several nervous loops connecting the cerebral cortex, brainstem nuclei and thoraco-lumbar, pelvic and pudendal ganglia. A lesion of one or more of these nuclei and/or neurologic circuits involves a dysfunction of the lower urinary tract. Usually, in case of complete lesion of spinal cord, there is a strict correlation between the level of the neurological lesion and the dysfunction of the lower urinary tract. On the other hand, in case of incomplete lesion of spinal cord or neurological disease, this correlation is often lacking. Herein data regarding 55 patients affected with neurologic lesion of different etiology, in whom it was always possible to identify the level of the lesion, have been retrospectively reviewed. Videourodynamic (VUD) demonstrated vesico-sphincterial dysfunctions according to both the lesion level and physical neurological examination in 67% of patients. On the other hand, in a significant percentage (24.7%) a variance between the level of the neurological lesion and the VUD finding was pointed out. Despite a neurological lesion, in the remaining 8.3% VUD showed normal finding. Of significance, in our series a more strict correlation between lesion level and urodynamic finding was found among patients with spinal cord trauma (80% of cases). As such, VUD is still a first step diagnostic tool in order to adequately investigate lower urinary tract dysfunctions due to neurologic involvement. Furthermore, it is even unreplaceable in those patients (24.7% in our series) in whom the urodynamic finding is not in accordance with the level of neurologic lesion and physical neurological examination. Therefore, when approaching such patients, only a complete videourodynamic testing allows to get enough information to institute the most adequate endoscopic and/or surgical procedure in order to preserve the upper urinary tract.
|Number of pages||6|
|Publication status||Published - 1998|
- Neurogenic bladder
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