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High percentage of neurologic deficits in the electrophysiology study of the lower urinary tract in patients with detrusor underactivity and chronic urinary retention
- Source :
- Neurourology and Urodynamics. 40:883-890
- Publication Year :
- 2021
- Publisher :
- Wiley, 2021.
-
Abstract
- Objectives Both detrusor underactivity (DU) and bladder outlet obstruction are the common causes of chronic urinary retention. Some novel treatment approaches focus on modulating micturition reflex and external urethral sphincter (EUS) function. This study used electrophysiologic (EP) studies to investigate the micturition reflex and EUS conditions of chronic urinary retention patients. Methods Sixty patients with urodynamic DU and chronic urinary retention were studied using (1) bulbocavernous reflex (BCR) by electric stimulation, (2) electromyography (EMG) of the EUS, and (3) nerve conduction velocity (NCV) studies of the pudendal nerve. The EP findings were analyzed in DU patients with different etiologies. Results The BCR was positive in 41.7% of patients. In EMG studies, denervation, reinnervation, and reduced recruitment of the EUS were observed in 21.7%, 71.7%, and 88.3% patients, respectively. Decreased amplitude of pudendal nerve conduction in NCV studies was noted in 73.3% of patients. Patients with sacral neuropathy had a lower BCR positive rate (p = 0.001), a nonsignificant but higher denervation rate (p = 0.059) in EMG studies, and a higher rate of decreased amplitude in NCV (p = 0.011) than those without sacral neuropathy. Excluding patients with sacral neuropathy or diabetes mellitus, a high percentage of neurologic deficits was still detected in EP studies. Conclusions Chronic urinary retention patients with urodynamic DU not only have bladder dysfunction, but also potential neuropathy in the sacral reflexes, pudendal nerve, or urethral sphincter innervation. The neurologic deficits explored in EP studies may affect the decision-making around the therapy to restore the voiding function in DU.
- Subjects :
- Male
medicine.medical_specialty
Urology
Pudendal nerve
Urinary system
030232 urology & nephrology
Nerve conduction velocity
03 medical and health sciences
Bladder outlet obstruction
0302 clinical medicine
Bulbocavernosus reflex
Urinary Bladder, Underactive
Humans
Medicine
Aged
Retrospective Studies
030219 obstetrics & reproductive medicine
business.industry
Urinary retention
Urethral sphincter
Urinary Retention
Electrophysiology
Urinary Bladder Neck Obstruction
Urodynamics
Chronic Disease
Reflex
Female
Neurology (clinical)
medicine.symptom
business
Subjects
Details
- ISSN :
- 15206777 and 07332467
- Volume :
- 40
- Database :
- OpenAIRE
- Journal :
- Neurourology and Urodynamics
- Accession number :
- edsair.doi.dedup.....7b1f3a1236385c64aa2f617564b8e26e