Martínez CPR, Rodríguez CES, Escobar BL, Guzmán RR

Language: Spanish
References: 4
Page: 603-607
PDF size: 180.39 Kb.

ABSTRACT

Background: Anatomical alterations in bony structures, as the sacrum, can be related with defects in nervous supply to pelvic viscera and low urinary tract.
Objective: To relate location of damages at spina bifida occult with diagnosis of overactive bladder.
Material and methods: Cross sectional study between December 2005 and March 2006 in 31 patients with diagnose of overactive bladder. All of them with complete medical history, uroneurologic physical exam, multichannel urodynamic study, urethrocystoscopy, urine culture, bladder voiding, life quality questionnaire, and antero subsequent, sacred lateral and lumbar column x-ray. Statistical analysis was done through distribution frequencies graphics and averages comparison.
Results: Age average was 47 years, 20 to 69 years; gestations average was four and childbirth average was three by patient. Highest percentage of dysraphia was located between S2 to S5 in 29 patients (94%), and between L5 to S5 in 2 patients (6%). Other findings were: scoliosis in 20 patients (64.5%), asymmetry of hip in 9 patients (29%), and lordosis in 7 patients (22.5%); spondilolistesis, lumbarization of S1 and sacralization of L5 were found each one in a patient (22.5%).
Conclusions: In 94% of patients, presence of spina bifida occult between S2 to S4 correlates with the diagnosis of overactive bladder. Another type of alteration, as lordosis and scoliosis, are findings in a high percentage of patients and can be related to symptoms of overactive bladder.

REFERENCES

1. Albright TS, Gebrich AP, Wright J, Davis GD. Neurophysiology of the pelvic floor and neurodiagnostic evaluation. J Pelvic Med Surg 2004;10:123-38.

2. Samuel M, Boddy SA. Is spina bifida occulta associated with lower urinary tract dysfunction in children? J Urol 2004;171:2664-6.

3. Bruner JP, Tulipan N, Dabrowiak ME, Luker KS, et al. Upper level of the spina bifida defect: how good are we? Ultrasound Obstet Gynecol 2004;24:612-7.

4. Van der Pal F, Heesakkers JPFA, Bemelmans BLH. Current opinion on the working mechanisms of neuromodulation in the treatment of lower urinary tract dysfunction. Curr Opin Urol 2006;16:261-7.