title: The Factors That Affect Improvement of Neurogenic Bladder by Severe Lumbar Disc Herniation in Operation.
abstract: OBJECTIVE
  This study analyzed retrospectively the bladder function of patients after early surgery for cauda equina syndrome (CES) performed within 24 or 48 hours, or after 48 hours of the onset of autonomic symptoms.
  
  
  METHODS
  We retrospectively reviewed the clinical data of 31 patients after decompression surgery for lumbar disc herniation (LDH) who had been diagnosed with CES between January 2001 and December 2014 at Inha University Hospital. The following factors were assessed to evaluate the influence of time to surgery: bladder function, rectal incontinence, sexual dysfunction, LDH level, and degree of spinal canal compression.
  
  
  RESULTS
  After decompression, the outcome group was categorized into normal bladder function and abnormal bladder function. The patients operated on within 48 hours showed an improved postoperative outcome. Among 16 patients operated on within 48 hours, 13 (81%) recovered normal bladder function. In contrast, among 15 patients with decompression after 48 hours, 6 (40%) recovered normal bladder function. Among 21 patients with mild bladder dysfunction at admission, 16 (76%) recovered normal bladder function after decompression.
  
  
  CONCLUSIONS
  Our study suggests that patients who have decompression surgery within 48 hours of the onset of bladder dysfunction, improve their chances of recovering bladder function than those who have a late operation (>48 hours). Also, patients with mild bladder dysfunction are more likely to recover bladder function after decompression, than patients with severe bladder dysfunction.
authors: Department of Neurosurgery, Inha University School of Medicine, Incheon, Korea.
authors: Joon Bok
authors: JB
authors: Jeon
authors: Department of Neurosurgery, Inha University School of Medicine, Incheon, Korea.
authors: Seung Hwan
authors: SH
authors: Yoon
authors: Department of Neurosurgery, Inha University School of Medicine, Incheon, Korea.
authors: Do Keun
authors: DK
authors: Kim
authors: Department of Neurosurgery, Naeun Hospital, Incheon, Korea.
authors: Ji-Yong
authors: JY
authors: Kim
keywords: Intervertebral disc displacement; Neurogenic urinary bladder; Polyradiculopathy; Spinal cord compression; Treatment outcome