title: Lower urinary tract symptoms of neurological origin in urological practice.
abstract: OBJECTIVE
  The present study aimed to reveal the neurological origin of lower urinary tract symptoms (LUTS) in routine urological examination.
  
  
  METHODS
  We retrospectively analyzed 70 cases to identify cases in which the neurologist and/or urologist suspected the relation between neurological diseases and LUTS. The compromised neurological areas were categorized into brain and spinal cord based on the appearance time of LUTS and presence/absence of disease specificity. We classified the lesion site based on the imaging result and the neurologic finding. We compared LUTS appearance time: from LUTS appearance till the first visit to urologist (first visit urologist) and from the aforementioned visit till the neurological diagnosis confirmation (neurological diagnosis). Finally, we conducted a detailed investigation of the surgical cases, as well as those with urodynamic studies (UDS) performed prior to the neurological examination.
  
  
  RESULTS
  The neurological diseases involved 31 cases (44 %) of multiple system atrophy, 11 (16 %) of multiple sclerosis, and 4 (6 %) of Parkinson's disease. Associated symptoms comprised gait disturbance (38) and lower limb dysesthesia (20), while no associated symptoms were observed in 13 (19 %). Both the periods proved significantly shorter for spinal cord disease. Urological surgeries were performed in 10 cases (14 %). UDS findings revealed 10 cases of decrease in bladder compliance, and 15 of detrusor underactivity; no normal cases were observed.
  
  
  CONCLUSIONS
  Consideration of detailed medical history, enforcement of UDS, and closer cooperation between urologists and neurologists are required to ascertain early and correct diagnosis, and to avoid unnecessary surgery.
authors.affiliation: Department of Urology, Kurosawa Hospital, 3-19-2 Nakai-Machi, Takasaki, Gunma 370-0852, Japan. magari@showa.gunma-u.ac.jp
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Magari
authors.forename: Yoshitatsu
authors.initials: Y
authors.lastname: Fukabori
authors.forename: Haruyuki
authors.initials: H
authors.lastname: Ogura
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Suzuki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000175:diagnosis* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000150:complications* / Q000175:diagnosis*; D012189:Retrospective Studies; D055815:Young Adult