ORIJINAL ARAŞTIRMA
Lomber ve Lumbosakral Disk Herniasyon Cerrahisi Sonrası Nörojenik Mesaneli Hastaların Değerlendirilmesi: Retrospektif Kesitsel Bir Çalışma
Evaluation of Patients with Neurogenic Bladder Following Lumbar and Lumbosacral Disc Herniation Surgery: A Retrospective Cross-Sectional Study
Received Date : 18 May 2023
Accepted Date : 22 Aug 2023
Available Online : 08 Sep 2023
Gülsemin ERTÜRK ÇELİKa Murat ERSÖZb,c, Ender ERDENb, Ebru ERDENb
aRepublic of Türkiye Ministry of Youth and Sports, Ankara, Türkiye
bClinic of Physical Medicine and Rehabilitation, Ankara Physical Therapy and Rehabilitation Training and Research Hospital, Ankara, Türkiye
cDepartment of Physical Medicine and Rehabilitation, Ankara Yıldırım Beyazıt University Faculty of Medicine, Ankara, Türkiye
Doi: 10.31609/jpmrs.2023-98028 - Makale Dili: EN
J PMR Sci 2024;27(1):49-55.
ÖZET
Amaç: Bu çalışmanın amacı, lomber ve lumbosakral disk hernisi
cerrahisi sonrası hastaların böbrek, mesane fonksiyonları ve ürodinamik
özelliklerini araştırmaktır. Gereç ve Yöntemler: Bu retrospektif çalışmaya
lomber disk hernisi cerrahisi geçirmiş 28 hasta dâhil edildi. Demografik ve
klinik veriler toplandı. Alt gruplarda cinsiyet, mesane dolum hissi ve postoperatif
süreye göre veri karşılaştırmaları yapıldı. Bulgular: Yaş ortalaması
52,9±12,7 yıl olan toplam 28 (16 erkek, 12 kadın) hasta çalışmaya
alındı. Lomber disk operasyonundan bu yana geçen ortalama süre 26,1±27,1
ay idi. Hastalar hastalık süresine göre (<6 ay, ≥6 ay) iki gruba ayrıldığında,
başvuru sırasındaki boşaltma yönteminde istatistiksel olarak anlamlı farklılık
gözlendi (p=0,024). Benzer şekilde, hastalar cinsiyete göre (erkek-kadın)
iki gruba ayrıldığında başvuru sırasındaki boşaltma yönteminde istatistiksel
olarak anlamlı farklılık gözlendi (p=0,049). Kalıcı üretral kateter kullanım
sıklığı erkek hastalarda ve hastalık süresi <6 ay olan hastalarda daha yüksek
iken, katetersiz spontan işeme/boşaltma sıklığı kadın hastalarda ve hastalık
süresi ≥6 ay olan hastalarda daha yüksekti. Sonuç: Postoperatif süresi kısa
olan hastalarda ve erkek hastalarda daha yüksek kalıcı üretral kateter kullanım
sıklığı gözlendi. Kalıcı üretral kateter kullanan hastaların en kısa sürede
değerlendirilmesi ve spontan işeme veya aralıklı kateterizasyona
geçilmesi, bu hastalarda kalıcı üretral kateterin yan etkilerini azaltacaktır.
Anahtar Kelimeler: Nörojenik mesane; lomber disk herniasyon; ürodinamik değerlendirme
ABSTRACT
Objective: The aim of this study was to explore the urodynamic
features and renal/bladder functions in patients following lumbar or
lumbosacral disc herniation surgery. Material and Methods: This retrospective
study included 28 patients with a history of lumbar disc herniation
surgery. Demographic and clinical data were collected. Data comparisons
were performed in the subgroups according to gender, bladder filling sensation,
and postoperative duration. Results: A total of 28 patients (16 males,
12 females) with a mean age of 52.9±12.7 years were enrolled. The mean
duration since the lumbar disc operation was 26.1±27.1 months. When the
patients were separated into two groups with respect to postoperative duration
(<6 months, ≥6 months) statistically significant difference was observed
in emptying method at admission (p=0.024). Similarly, when the patients
were separated into two groups with respect to gender (male-female) statistically
significant difference was observed in emptying method at admission
(p=0.049). Frequency of indwelling urethral catheter use was higher in
male patients and in patients with postoperative duration <6 months while
spontaneous voiding/emptying without catheter frequencies were higher in
female patients and in patients with a postoperative duration of ≥6 months.
Conclusion: Higher indwelling urethral catheter frequencies observed in
patients with short postoperative duration and in male patients. Evaluation
of the patients with indwelling urethral catheters as soon as possible and
shifting to spontaneous voiding or intermittent catheterisation will diminish
the side effects of indwelling urethral catheters in these patients.
Keywords: Neurogenic bladder; lumbar disc herniation; urodynamic evaluation
REFERENCES
- Dong D, Xu Z, Shi B, et al. Urodynamic study in the neurogenic bladder dysfunction caused by intervertebral disk hernia. Neurourol Urodyn. 2006;25:446-50. [Crossref] [PubMed]
- Siracusa G, Sparacino A, Lentini VL. Neurogenic bladder and disc disease: a brief review. Curr Med Res Opin. 2013;29:1025-31. [Crossref] [PubMed]
- Kawaguchi Y, Kanamori M, Ishihara H, et al. Clinical symptoms and surgical outcome in lumbar spinal stenosis patients with neuropathic bladder. J Spinal Disord. 2001;14:404-10. [Crossref] [PubMed]
- Ahn UM, Ahn NU, Buchowski JM, et al. Cauda equina syndrome secondary to lumbar disc herniation: a meta-analysis of surgical outcomes. Spine (Phila Pa 1976). 2000;25:1515-22. [Crossref] [PubMed]
- Przydacz M, Chlosta P, Corcos J. Recommendations for urological follow-up of patients with neurogenic bladder secondary to spinal cord injury. Int Urol Nephrol. 2018;50:1005-16. [Crossref] [PubMed]
- Elmelund M, Oturai PS, Biering-Sørensen F. 50 years follow-up on plasma creatinine levels after spinal cord injury. Spinal Cord. 2014;52:368-72. [Crossref] [PubMed]
- Sepahpanah F, Burns SP, McKnight B, et al. Role of creatinine clearance as a screening test in persons with spinal cord injury. Arch Phys Med Rehabil. 2006;87:524-8. [Crossref] [PubMed]
- O'Flynn KJ, Murphy R, Thomas DG. Neurogenic bladder dysfunction in lumbar intervertebral disc prolapse. Br J Urol. 1992;69:38-40. [Crossref] [PubMed]
- Mosdal C, Iversen P, Iversen-Hansen R. Bladder neuropathy in lumbar disc disease. Acta Neurochir (Wien). 1979;46:281-6. [Crossref] [PubMed] [PMC]
- Inui Y, Doita M, Ouchi K, et al. Clinical and radiologic features of lumbar spinal stenosis and disc herniation with neuropathic bladder. Spine (Phila Pa 1976). 2004;29:869-73. [Crossref] [PubMed]
- Schöps TF, Schneider MP, Steffen F, et al. Neurogenic lower urinary tract dysfunction (NLUTD) in patients with spinal cord injury: long-term urodynamic findings. BJU Int. 2015;115 Suppl 6:33-8. [Crossref] [PubMed]
- Corcos J, Przydacz M. Hydronephrosis. In: Corcos J, Przydacz M, eds. Consultation in Neurourology: a Practical Evidence-Based Guide. 1st ed. Cham: Springer; 2017. p.213-28 [Crossref]
- Cameron AP, Rodriguez GM, Schomer KG. Systematic review of urological followup after spinal cord injury. J Urol. 2012;187:391-7. [Crossref] [PubMed]
- Meldrum KK. Pathophysiology of urinary tract obstruction. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia: Elsevier; 2016. p.1089-103.
- Wyndaele JJ. The normal pattern of perception of bladder filling during cystometry studied in 38 young healthy volunteers. J Urol. 1998;160:479-81. [Crossref] [PubMed]
- Wyndaele JJ, De Wachter S. Cystometrical sensory data from a normal population: comparison of two groups of young healthy volunteers examined with 5 years interval. Eur Urol. 2002;42:34-8. [Crossref] [PubMed]
- Consortium for Spinal Cord Medicine. Bladder management for adults with spinal cord injury: a clinical practice guideline for health-care providers. J Spinal Cord Med. 2006;29:527-73. [PubMed] [PMC]
- Dmochowski R. Cystometry. Urol Clin North Am. 1996;23:243-52. [Crossref] [PubMed]
- Ersoz M, Tunc H, Akyuz M, et al. Bladder storage and emptying disorder frequencies in hemorrhagic and ischemic stroke patients with bladder dysfunction. Cerebrovasc Dis. 2005;20:395-9. [Crossref] [PubMed]
- Ersoz M, Akyuz M. Bladder-filling sensation in patients with spinal cord injury and the potential for sensation-dependent bladder emptying. Spinal Cord. 2004;42:110-6. [Crossref] [PubMed]
- Pannek J, Blok B, Castro-Diaz D, et al. Guidelines on Neurogenic Lower Urinary Tract Dysfunction. European Association of Urology. 2013. Available from [Link]
- Akkoc Y, Cinar Y, Kismali E. Should complete and incomplete spinal cord injury patients receive the same attention in urodynamic evaluations and ultrasonography examinations of the upper urinary tract? Int J Rehabil Res. 2012;35:178-80. [Crossref] [PubMed]
- Shapiro S. Cauda equina syndrome secondary to lumbar disc herniation. Neurosurgery. 1993;32:743-6; discussion 746-7. [Crossref] [PubMed]
- Bartolin Z, Vilendecic M, Derezic D. Bladder function after surgery for lumbar intervertebral disk protrusion. J Urol. 1999;161:1885-7. [Crossref] [PubMed]
- Ersöz M, Sayılır S. Protective effect of preserved bladder-filling sensation on upper urinary tract in patients with spinal cord injury. Neurol Sci. 2014;35:1549-52. [Crossref] [PubMed]
- Bartolin Z, Gilja I, Bedalov G, et al. Bladder function in patients with lumbar intervertebral disk protrusion. J Urol. 1998;159:969-71. [Crossref] [PubMed]
- Gerridzen RG, Thijssen AM, Dehoux E. Risk factors for upper tract deterioration in chronic spinal cord injury patients. J Urol. 1992;147:416-8. [Crossref] [PubMed]
- Nosseir M, Hinkel A, Pannek J. Clinical usefulness of urodynamic assessment for maintenance of bladder function in patients with spinal cord injury. Neurourol Urodyn. 2007;26:228-33. [Crossref] [PubMed]
- Yalçın S, Ersöz M. Urodynamic findings, bladder emptying methods and therapeutic approaches in patients with upper lumbar and lower lumbar-sacral spinal cord injury. Neurol Sci. 2015;36:2061-5. [Crossref] [PubMed]
- Hao Y, Xin M, Wang S, et al. Myelopathy associated with mixed connective tissue disease: clinical manifestation, diagnosis, treatment, and prognosis. Neurol Sci. 2019;40:1785-97. [Crossref] [PubMed]
- Ghasemi V, Simbar M, Ozgoli G, et al. Prevalence, dimensions, and predictor factors of sexual dysfunction in women of Iran Multiple Sclerosis Society: a cross-sectional study. Neurol Sci. 2020;41:1105-13. [Crossref] [PubMed]
