The evaluation of bladder symptoms in patients with lumbar compression disorders who have undergone decompressive surgery.
METHODS
Prospective cohort study.


OBJECTIVE
We study the relationship between the degree of dural sac compression, the prevalence of lower urinary tract symptoms, and the effect of surgical decompression in patients with lumbar spinal canal compression using the American Urological Association Symptom Score (AUAss).


BACKGROUND
Patients with lumbar spinal canal compression not only experienced leg neuropathy but also lower urinary tract symptoms. There are few reports concerning the prevalence of bladder symptoms and the effect of decompression on urinary symptoms.


METHODS
We enrolled 245 patients, who were admitted for decompression of lumbar spinal canal compression, using the AUAss) On the basis of the score, patients were divided into 2 groups: those with significant neurologic bladder symptoms (high AUAss), and those without significant symptoms (low AUAss). The narrowest anteroposterior diameter of the dural sac at the corresponding level of decompression on axial magnetic resonance imaging (MRI) was measured for both groups. The Oswestry Disability Index and AUAss were compared before and after decompressive surgery. The urodynamic change in the group of high AUAss after surgery was analyzed.


RESULTS
A total of 67 patients (27%) had significant lower urinary tract symptoms in our study group. The mean/median number of levels decompressed was 1.5/1 in high AUAss and 1.8/2 in low AUAss group. Decompressive surgery had beneficial effect on both the AUAss and Oswestry Disability Index in both groups. The postvoid residual urine volume was significantly reduced after surgical decompression. The narrowest diameter of dural sac on MRI has correlation with AUAss.


CONCLUSIONS
We found that 27% patients with lumbar spinal compression disorders had lower urinary tract symptoms; the anteroposterior diameter of dural sac measured on axial MRI is correlated with the lower urinary tract symptoms. After the decompressive surgery, the most sensitive indicator of bladder dysfunction was subjective symptoms and postvoid residual voiding volume.
Tsai
Chun-Hao
CH
Departments of Orthopedics, China Medical University Hospital, Taichung, Taiwan, People's Republic of China.
Chou
Eric Chieh-Lung
EC
Chou
Li-Wei
LW
Chen
Yen-Jen
YJ
Chang
Chia-Hao
CH
Tsou
Hsi-Kai
HK
Chen
Hsien-Te
HT
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019299:Decompression, Surgical; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D011859:Radiography; D013130:Spinal Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011795:Surveys and Questionnaires; D014563:Urodynamics; D014570:Urologic Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*