Document Detail


Lower urinary tract symptoms following neurological illness may be influenced by multiple factors: observations from a neurorehabilitation service in a developing country.
MedLine Citation:
PMID:  19475575     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: To evaluate the pattern of lower urinary tract dysfunction (LUTD) in patients with neurological disease in the setting of a rehabilitation service in a developing country, and analyze causes for unexpected lower urinary tract symptoms (LUTS). METHODS: Patients with neurological disorders and having significant LUTS were prospectively evaluated. Level of neurological lesion was localized by neurological examination and investigations. LUTD was evaluated by symptom analysis, bladder diaries and ultrasonography. Storage symptoms were managed using antimuscarinic medications and voiding dysfunction, when significant, was managed by catheterization and patients were regularly followed up. Patients with symptoms that had not been expected based upon their level of neurological lesion were further evaluated. RESULTS: Fifty patients (mean age 43.5 +/- 18.3 years) were included and according to neurological localization, were categorized into suprapontine (n = 9; 18%), infrapontine/suprasacral (n = 25; 50%) or infrasacral (n = 16; 32%) groups. Incontinence was more common in patients with suprapontine and infrapontine/suprasacral lesions (n = 20) (P < 0.03), hesitancy more common with infrapontine/suprasacral lesions (n = 20) (P = 0.004) and retention more with infrasacral lesions (n = 13) (P < 0.001). Patients belonging to suprapontine and infrapontine/suprasacral groups more likely showed improvement at follow up (P = 0.008). Fourteen patients (28%) had unexpected LUTS and this was due to urological causes (n = 6) or multiaxial neurological involvement (n = 8). Potentially treatable factors were managed, resulting in symptom relief. CONCLUSION: LUTS in neurological disease may be at variance with the pattern expected based upon level of neurological lesion. Such patients may require further evaluation and consideration should be given to concomitant urological conditions and multiaxial neurological involvement.
Authors:
Jalesh N Panicker; Lakshmi Menon; A Anandkumar; K R Sundaram; Clare J Fowler
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurourology and urodynamics     Volume:  29     ISSN:  1520-6777     ISO Abbreviation:  Neurourol. Urodyn.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-29     Completed Date:  2010-06-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8303326     Medline TA:  Neurourol Urodyn     Country:  United States    
Other Details:
Languages:  eng     Pagination:  378-81     Citation Subset:  IM    
Copyright Information:
(c) 2009 Wiley-Liss, Inc.
Affiliation:
Department of Neurology, Amrita Institute of Medical Sciences, Kochi, India. jaleshp@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Developing Countries*
Female
Humans
India
Male
Nervous System Diseases / complications*
Prospective Studies
Urination Disorders / diagnosis*,  etiology*

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