V Mak1, S B Radomski. 1. Division of Urology, University of Toronto, Ontario, Canada.
Abstract
PURPOSE: We evaluated the role of magnetic resonance imaging (MRI) of the lumbosacral spinal cord in patients with voiding complaints and abnormal urodynamic findings but normal neurological and lower spine examinations. MATERIALS AND METHODS: We studied 17 women and 13 men 17 to 50 years old (mean age 32.2) who presented with voiding complaints. All patients had a completely normal neurological examination and no evidence of prostatic enlargement. Of the 30 patients 18 had incontinence (17 urge, and 1 stress and urge), 9 frequency and urgency alone, and 3 urinary retention. Seven patients had persistent enuresis (2 primary and 5 secondary). All 30 patients underwent multichannel urodynamics and MRI of the lower spinal cord. RESULTS: On urodynamic testing, 25 patients had bladder instability, 3 a hypocontractile or weak detrusor, 1 significantly decreased sensation only and 1 stress incontinence. No patient had detrusor external sphincter dyssynergia or outflow obstruction. Only 1 patient with frequency and urgency had a significant finding on MRI (tethered cord) that required surgery. CONCLUSIONS: In young adults who have voiding complaints and abnormal urodynamic findings, with normal neurological and lower spine examinations, the value of MRI of the lumbosacral spine is limited.
PURPOSE: We evaluated the role of magnetic resonance imaging (MRI) of the lumbosacral spinal cord in patients with voiding complaints and abnormal urodynamic findings but normal neurological and lower spine examinations. MATERIALS AND METHODS: We studied 17 women and 13 men 17 to 50 years old (mean age 32.2) who presented with voiding complaints. All patients had a completely normal neurological examination and no evidence of prostatic enlargement. Of the 30 patients 18 had incontinence (17 urge, and 1 stress and urge), 9 frequency and urgency alone, and 3 urinary retention. Seven patients had persistent enuresis (2 primary and 5 secondary). All 30 patients underwent multichannel urodynamics and MRI of the lower spinal cord. RESULTS: On urodynamic testing, 25 patients had bladder instability, 3 a hypocontractile or weak detrusor, 1 significantly decreased sensation only and 1 stress incontinence. No patient had detrusor external sphincter dyssynergia or outflow obstruction. Only 1 patient with frequency and urgency had a significant finding on MRI (tethered cord) that required surgery. CONCLUSIONS: In young adults who have voiding complaints and abnormal urodynamic findings, with normal neurological and lower spine examinations, the value of MRI of the lumbosacral spine is limited.