Urodynamic of lower urinary tract in spinal tuberculosis after surgery

Abstract

Spinal tuberculosis can lead to neurogenic disturbancesin 10–61.6%. Patients undergo surgery due to neurological complications, but there is lack of publications for recovery of neurogenic lower urinary tract dysfunction after surgery.

Objective. To evaluate changes in urodynamic parameters after spinal surgery in patients with tuberculous spondylitis and neurogenic dysfunction of the lower urinary tract.

Materials and me thods. We observed 49 patients with spinal tuberculosis, who had symptoms of micturition’s impairment. Before the operation, detrusor overactivity was detected in 13 (26.5%) patients, and in 9 more cases (18.4%) — a combination of detrusor overactivity with detrusorsphincter dissinergia. Violation of the contractile function of the bladder in the form of hypo- or acontractility of detrusor was diagnosed in 22 patients (44.9%). Isolated detrusor-sphincter dissinergia was diagnosed in 5 patients (10.2%). In the postoperative period, an improvement in urodynamic parameters was noted in 15 cases (30.6%). In 4 patients, no urodynamic disorders were detected during the control examination. In 7 cases (14.3%), the conversion of one type of dysfunction to another was observed, in all other cases, the nature of urodynamic disorders in the early postoperative period did not change.

Conclusion. In the early postoperative period, urodynamic parameters after spinal surgery improve in 30.6% of patients. In 14.3% of cases, there are changes in the type of neurogenic dysfunction. Urodynamic disorders persist in a significant number (55.1%) of patients.