Bladder dysfunction in patients with cauda equina lesions

Podnar, Simon; Tršinar, Bojan; Vodušek, David B.

doi:10.1002/nau.20188

Cited by 74 publications

(48 citation statements)

References 33 publications

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“…For perianal sensation, a composite score was produced by summation of scores from both sides. 5,6 The penilo-cavernosus reflex was elicited by brisk compression of the glans penis between the first three fingers. Movement of the perineum was carefully observed, and if an unequivocal response could be seen, the reflex was regarded as normal.…”

Section: Methodsmentioning

confidence: 99%

Clinical and neurophysiologic testing of the penilo‐cavernosus reflex

Podnar

2007

Neurourology and Urodynamics

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Section: Methodsmentioning

confidence: 99%

Clinical and neurophysiologic testing of the penilo‐cavernosus reflex

Podnar

2007

Neurourology and Urodynamics

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“…Linear regression showed that the loss of perineal sense and female sex have a positive impact on patients' urinary incontinence. The study concluded that due to poor communication between urodynamic study fi ndings and the symptoms, it does not have induction in the diagnosis of disease (20). In a study by Lazaaro et al in 2004, eff ects and changes of electromy- Table 2.…”

Section: Discussionmentioning

confidence: 99%

Examination of The Predictive Power of Electromyography and Urodynamic Study in Patients with Cauda Equina Syndrome (Horse Tail Syndrome)

Shahmohammadi¹,

Khoshuod²,

Zali³

et al. 2016

Acta Inform Med

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Background: Cauda equina syndrome is a rare disorder that causes loss of Lumbar plexus function (nerve roots) lower than conus medullaris. No risk factor has been defined for this disease yet. Due to the high morbidity of Cauda equina syndrome and lack of sufficient information about the connection between the disease and urodynamic findings and EMG (Electromyography) findings, the need for this comprehensive study is felt. Objective: The aim is to determine the predictive power of findings resulted from urodynamics and electromyography of perineal region and around sphincter in the clinical cure rate of urination in patients with urinary retention followed by Cauda equina syndrome. Method: Patients referred to Shohadaye Tajrish Hospital during the years 2009 to 2013, in case of having Cauda equina syndrome symptoms (confirmed with Lumbar MRI), were undergone urodynamic examination and perineal electromyography after surgical decompression action. These both assessments (urodynamic study and electromyography) were repeated during the follow-up of 15 patients in the first and sixth months after surgery and findings were compared with each other. Results: Among the Urodynamic findings, Qmax (maximum urine flow) during three studies had a significant relationship with long-term recovery rate of patients (P <0.05). The relationship had been more valuable in follow-ups after one month (P = 0.0001). Also, BCI (Bladder Contractility Index) in all three studies had a significant relationship with clinical improvement in the ability to urinate (P <0.001). The residual urine (PVR) compared to two previous urodynamic findings showed a less significant relationship with clinical cure rate (P = 0.04). Among the findings of muscle-nerve (MUAP Fibrillation, Positive sharp way) none of them had a significant relationship with cure rate. Conclusion: Urodynamic finding, especially Qmax and bladder contractility index, can be considered as predictive indicators for patients' recovery after surgery.

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“…To score the severity of sacral dysfunctions, Slovene versions of the standard urinary incontinence [3,5], anal incontinence [6], constipation [1], and male sexual dysfunction [16] questionnaires were used [9,14,15]. In all patients clinical examination was performed with emphasis on the lower limbs and sacral segments [13].…”

Section: Methodsmentioning

confidence: 99%

“…In addition, bladder, bowel, and sexual functions may also be disturbed [9,14,15,17]. The annual incidence rate of cauda equina lesions has been estimated at 3.4 per million population, and the period prevalence at 8.9 per 100,000 [11].…”

Section: Introductionmentioning

confidence: 99%

Cauda equina lesions as a complication of spinal surgery

Podnar

2009

Eur Spine J

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Although the most common aetiology of cauda equina lesions is lumbar intervertebral disc herniation, iatrogenic lesions may also be the cause. The aim of this study was to identify and present patients in whom cauda equina lesions occurred after spinal surgery. From the author's series of patients with cauda equina lesions, those with the appearance of sacral symptoms after spinal surgery were identified. To demonstrate lesions more objectively, electrodiagnostic studies were performed in addition to history and clinical examination. Imaging studies were also reviewed. Of 69 patients from the series, 11 patients in whom a cauda equina lesion developed after spinal surgery were identified. The aetiology comprised surgery for herniated intervertebral disc in 5 (4 performed by a single surgeon), spinal stenosis surgery in 4, and postoperative lumbar epidural haematoma in 2 patients (each performed by a different surgeon). Proportion of spinal surgeries with this complication varied from 0 to 6.6% in different centres. Patients with iatrogenic cauda equina lesion were significantly older (p \ 0.001), and reported more severe urinary, but similar bowel and sexual symptoms compared to other patients in the series. In conclusion the study identified spinal surgery as the cause of approximately 15% of cauda equina lesions. More than a third of lesions developed after procedures performed by a single surgeon. Most of the remaining lesions could probably be avoided by better surgical technique (e.g. the use of a high-speed drill instead of a Kerrison rongeur in patients with severe spinal stenosis), or prevented by closer postoperative monitoring (e.g. in patients with postoperative lumbar epidural haematoma).

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Bladder dysfunction in patients with cauda equina lesions

Cited by 74 publications

References 33 publications

Clinical and neurophysiologic testing of the penilo‐cavernosus reflex

Clinical and neurophysiologic testing of the penilo‐cavernosus reflex

Examination of The Predictive Power of Electromyography and Urodynamic Study in Patients with Cauda Equina Syndrome (Horse Tail Syndrome)

Cauda equina lesions as a complication of spinal surgery

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