Clinical, urodynamic and neurophysiological findings in patients with neuropathic bladder due to a lumbar intervertebral disc protrusion

Abstract

Sacral nerve roots are affected in 1 to 15% of reported cases of lumbar disc protrusions (mainly posterior) (Scott, 1965). Urinary retention is the commonest symptom. In the last 6 years, we have observed 22 patients (18 males and 4 females) with a neuropathic bladder due to this condition in the acute phase. They underwent intermittent catheterisation (IC), and manoeuvres such as Credé and Valsalva's at fixed times. Almost all obtained a balanced bladder. (Follow-up: 24 months.) The most common urodynamic finding at the onset was bladder areflexia with severe denervation of the perineal floor. At follow-up, 65% still had bladder areflexia and 29% normoreflexia, all with normal compliance. Perineal floor innervation showed a fair recovery, mainly in the efferent part. An hypothesis is presented to explain why this kind of neuropathic bladder has a normal compliance. © 1989 International Medical Society of Paraplegia.