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.