MP80-06 TRANSVERSE MYELITIS PATIENTS REQUIRE CLOSE UROLOGICAL SURVEILLANCE: RESULTS FROM A TERTIARY REFERRAL URODYNAMIC CENTER

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Neurogenic Voiding Dysfunction1 Apr 2014MP80-06 TRANSVERSE MYELITIS PATIENTS REQUIRE CLOSE UROLOGICAL SURVEILLANCE: RESULTS FROM A TERTIARY REFERRAL URODYNAMIC CENTER Rebecca Lavelle, Burhan Coskun, Louise A. Gliga, Benjamin Greenberg, Maude E. Carmel, and Gary E. Lemack Rebecca LavelleRebecca Lavelle More articles by this author , Burhan CoskunBurhan Coskun More articles by this author , Louise A. GligaLouise A. Gliga More articles by this author , Benjamin GreenbergBenjamin Greenberg More articles by this author , Maude E. CarmelMaude E. Carmel More articles by this author , and Gary E. LemackGary E. Lemack More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2529AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Transverse myelitis (TM) is a heterogenous inflammatory syndrome characterized by acute or subacute spinal cord dysfunction resulting in paresis, sensory deficit, and frequently significant symptomatic autonomic impairment. We sought to characterize the lower urinary tract dysfunction in patients with TM by describing urodynamic (UDS) findings in patients referred with TM and lower urinary tract symptoms (LUTS). METHODS This is a retrospective review from an IRB-approved neurogenic bladder database of patients followed for LUTS by a single surgeon between 2001 and 2013. Patient demographics (age, gender, BMI), baseline questionnaire data (PGI-S, UDI-6, OAB-Q) and UDS parameters were analyzed. UDS parameters assessed included mean cystometric capacity (MCC), compliance, detrusor overactivity (DO), threshold volume (TV) at first involuntary contraction, maximum detrusor pressure (pdet.max), detrusor sphincter dyssynergia (DSD), post void residual (PVR), as well as pressure flow parameters. RESULTS Of the 836 patients with neurogenic bladder conditions in our database, 19 patients (13 females, 6 males) were referred with a principle diagnosis of TM (2.3%). Fifteen of 19 (78.9%) underwent UDS testing. Overall, mean age was 53 years (31-72), and mean age at diagnosis of TM was 47 years (2-69). Mean time from TM diagnosis to UDS was 31 months (3-153). Level of injury was cervical in 8 patients and thoracic in 10 patients, with 1 patient’s level of injury unknown. Bladder management at baseline was CIC or urethral catheter for 10/19 patients (52.6%). Mean MCC was 312 mL ± 207.1, DO was present in 12/15 (80%), DSD in 6/15 (40%), and decreased compliance in 5/15 (33.3%). The mean TV was 175 mL ± 96, and mean pdet.max was 49 ± 20.8 cmH20. Five patients (33.3%) were unable to void during UDS. For those voiding, mean Qmax was 13.5 ± 11.6 ml/sec and pdet at Q max was 39.8 ± 17.7 cmH20. No correlation was found between questionnaire data and UDS parameters (Table 1). CONCLUSIONS Significant UDS abnormalities are noted in the majority of TM patients referred with LUTS, with over 30% having altered compliance. Patients with TM require ongoing close surveillance of lower urinary tract dysfunction and urological care based on these data. Table 1. TM Patient Characteristics and Questionnaire Data Age, yrs, mean (range) 53 (31-72) Gender Male, n (%) 6 (31.6%) Female, n (%) 13 (68.4%) BMI, mean ± SD 26.6 ± 5.64 OABq-SF∗, mean ± SD 23.1 ± 10.1 UDI-6∗, mean ± SD 10.0 ± 4.2 PGI-S∗, mean ± SD 3.4 ± 0.5 ∗ OABq-SF = Overactive Bladder Questionnaire (Score 6-36), UDI-6 = Urogenital Distress Inventory (Score 0-18), PGI-S = Patient Global Impression of Severity (Score 1-4) © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e940 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Rebecca Lavelle More articles by this author Burhan Coskun More articles by this author Louise A. Gliga More articles by this author Benjamin Greenberg More articles by this author Maude E. Carmel More articles by this author Gary E. Lemack More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...