You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Non-Neurogenic Voiding Dysfunction I1 Apr 20101534 EFFECTS OF THORACIC EPIDURAL ANALGESIA ON LOWER URINARY TRACT FUNCTION Thomas M. Kessler, Patrick Y. Wuethrich, Bernhard Kiss, and Fiona C. Burkhard Thomas M. KesslerThomas M. Kessler More articles by this author , Patrick Y. WuethrichPatrick Y. Wuethrich More articles by this author , Bernhard KissBernhard Kiss More articles by this author , and Fiona C. BurkhardFiona C. Burkhard More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1285AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The need for an indwelling transurethral catheter in patients with postoperative thoracic epidural analgesia (TEA) is a matter of controversy. Since segmental blockade can be achieved with epidural analgesia, we hypothesized that analgesia within segments T4 to T11 should have no or minimal influence on lower urinary tract function. Here we evaluated the effect of TEA on lower urinary tract function by urodynamic studies. METHODS In 26 patients (13 women, 13 men) with no preoperative lower urinary tract symptoms undergoing open kidney surgery by lumbotomy under TEA, we prospectively assessed changes in urodynamic parameters the day before and 2-3 days after surgery with the patients under TEA. RESULTS Before versus during TEA, there was a significant increase in post void residual (median, 30 mL versus 275 mL, p<0.001) and a significant decrease in maximum detrusor pressure (median, 31 cmH2O versus 22 cmH2O, p<0.001), detrusor pressure at maximum flow rate (median, 27 cmH2O versus 9 cmH2O, p<0.001), maximum flow rate (median, 14 mL/s versus 3 mL/s, p<0.001), and voided volume (median, 340 mL versus 65 mL, p<0.001). Bladder sensation, maximum cystometric capacity, and compliance were not influenced by TEA (p>0.1). CONCLUSIONS In contrast to our initial hypothesis, TEA has a significant effect on bladder emptying with clinically relevant post void residual necessitating catheterization. Bern, Switzerland© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e592 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Thomas M. Kessler More articles by this author Patrick Y. Wuethrich More articles by this author Bernhard Kiss More articles by this author Fiona C. Burkhard More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...