Lower urinary tract dysfunctions in patients with spinal cord tumors.
OBJECTIVE
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.


CONCLUSIONS
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.
Uchiyama
Tomoyuki
T
Department of Neurology, Chiba University School of Medicine, Chiba, Japan. uchito@jst.c-net
Sakakibara
Ryuji
R
Hattori
Takamichi
T
Yamanishi
Tomonori
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology; D012447:Sacrum; D013120:Spinal Cord Neoplasms / Q000150:complications*; D013904:Thoracic Vertebrae; D014554:Urination; D014563:Urodynamics; D014570:Urologic Diseases / Q000209:etiology* / Q000503:physiopathology