Two screening tests for urinary voiding dysfunction used in 209 consecutive patients undergoing lumbar spine operations

Abstract

Objective. A study of the prevalence of urinary voiding dysfunction was carried out preoperatively in 209 patients undergoing lumbar spine operations, using two non-invasive screening tests: free uroflowmetry and ultrasound measurement of residual urine. The value of using the two urodynamic screening tests in the evaluation of a larger group of patients with sciatica from disc lesions or spinal stenosis has not been published as an article before. Material and methods. In 209 consecutive patients, 159 with lumbar disc lesions and 50 with lumbar spinal stenosis, the main indications for operative treatment were pain and/or somatic paresis. In preoperative interviews, information about voiding, anal and sexual functions were obtained. Then uroflowmetry was performed and the volume of residual urine was measured. In this study, the definition of normal bladder function is based on normal flow rates, the shape of the curves, normal voided volumes and the absence of significant residual urine. Bladder dysfunction differs from normal function by one, two, three or all four of these parameters. Results. Normal bladder function was found in 66 patients (31.6%). The other 143 (68.4%) had signs that could indicate sensory paresis and/or neurogenic detrusor underactivity. Seventy-nine of the 143 were also tested 3 months postoperatively. In 58% the bladder function had improved. Conclusions. The very high prevalence of abnormal uroflowmetry and/or postvoiding residual urine suggestive of possible bladder dysfunction (68.4%) indicates that the two tests should be used routinely in cases of lumbar disc lesions and spinal stenosis. The two tests provide documentation of preoperative voiding function and a possibility of comparison with postoperative findings.

Key Words::

• Bladder dysfunction
• lumbar spine surgery
• prevalence
• residual urine
• sciatica
• uroflowmetry.

Declaration of interests: No funds were received in support of this work. The manuscript submitted does not contain information about medical devices/drugs. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.