Relationship between clinical data and urodynamic findings in patients with lumbar intervertebral disk protrusion.

The relationship between voiding disturbances and urodynamic diagnosis in patients with lumbar intervertebral disk protrusion is controversial. The objective of this study was to determine the association between clinical data and urodynamic diagnosis, in order to reveal whether bladder dysfunction can be assessed on the basis of urological symptoms and signs. We prospectively studied 122 patients with lumbar intervertebral disk protrusion. Detrusor areflexia was found in 32 of these patients, while in the remaining 90 detrusor activity was normal. All patients with detrusor areflexia reported difficulty voiding by abdominal straining. The patients with normal urodynamic findings were either free of voiding disturbances (77 patients) or complained of frequent voiding (13 patients). In conclusion, there are cases of lumbar intervertebral disk protrusion in which the presence of bladder dysfunction can be predicted on the basis of clinical urodynamic testing, i.e. clinical neurological alterations, decreased bladder sensation, voiding by straining, increased bladder capacity, residual volume, and intermittent or continuous low flow curve on free uroflowmetry.

Bladder function after surgery for lumbar intervertebral disk protrusion.

PURPOSE: Urodynamic changes following surgical treatment for lumbar intervertebral disk protrusion were prospectively studied. MATERIALS AND METHODS: We evaluated 98 patients with lumbar intervertebral disk protrusion. Urodynamic evaluation was performed in all patients before and after surgery, and included simultaneous measurement of intravesical and abdominal pressure during bladder filling and voiding, and uroflowmetry (pressure flow measurement). RESULTS: Of the 27 patients with detrusor areflexia preoperatively detrusor activity was normal in only 6 after surgical treatment. Of the 71 patients with normal urodynamic findings preoperatively the findings became abnormal after surgery in 7. CONCLUSIONS: Bladder function frequently remains unchanged after surgery for lumbar intervertebral disk protrusion.

Bladder function in patients with lumbar intervertebral disk protrusion.

PURPOSE: We prospectively studied the effect of lumbar intervertebral disk protrusion on bladder function. Cystometry findings were particularly examined according to spinal level of disk protrusion and urological symptoms. MATERIALS AND METHODS: We evaluated 77 men and 37 women 25 to 63 years old with lumbar intervertebral disk protrusion. Urodynamic investigation included uroflowmetry and simultaneous recording of intravesical, abdominal and detrusor pressure during bladder filling and voiding. RESULTS: Detrusor areflexia was noted in 31 of the 114 patients (27.2%), while detrusor activity was normal in the remaining 83. According to the spinal level of disk protrusion, detrusor areflexia was evident in 3 of the 8 cases of L3, 10 of the 54 L4 and 18 of the 52 L5 disk protrusion. All 31 patients with detrusor areflexia reported difficult voiding with straining. CONCLUSIONS: Detrusor areflexia develops in approximately a quarter of the patients with lumbar intervertebral disk protrusion. We did not find that the spinal level of lumbar disk protrusion had an effect on detrusor activity. All patients with detrusor areflexia had voiding disorders that manifested as voiding with straining.

Prostatitis in benign prostatic hyperplasia: a histological, bacteriological and clinical study.

The paper deals with the incidence of prostatitis in benign prostatic hyperplasia (BPH) and its effect on the postoperative course in the patients subject to the transvesical prostatectomy. The samples of urine and expressed prostatic secretion were bacteriologically analysed before the operation, and samples of urine on three occasions following the operation. Specimens of BPH tissue obtained by surgery were subjected to pathohistological and microbiological examination. The incidence of prostatitis was found to be 90.3%. In the specimens of BPH tissue obtained by transversal prostatectomy, Gram-positive microorganisms were isolated in 32.8% of the tissue. In particular, Staphylococcus epidermidis was found in 26.6% of BPH tissue. Gram-negative microorganisms were isolated in 30.8% of BPH tissue, and fungi in 2.9%. In 27.9% of BPH tissue a microorganism could not be isolated although pathohistological examination evidenced prostatitis. Therefore, in these cases etiology remained unclear. Patients with Gram-negative prostatitis had the highest number of complications and the longest period of postoperative hospitalization. Preoperative and postoperative antibiotic therapy reduced the incidence of postoperative complications and shortened the period of hospitalization in the patients with significant Gram-negative bacteriuria before operation, that is, in the patients with Gram-negative prostatitis in BPH.