척수염 환자에서의 요역동학적 검사

Abstract

Background: Voiding disturbance is one of the frequent symptoms of myelitis. Clinical manifestations of urinary disturbance in the patients with myelitis are results of the specific neurological lesion of the spinal cord, but can be varied. To determine the relationship between the neurological spinal cord level and bladder dysfunction, we analyzed the urodynamic studies of patients with myelitis who complained of urinary symptoms. Methods: We investigated the urodynamic study in 30 patients with myelitis with urinary symptoms. Neurological examination and spinal MR imaging determined the clinical and radiological spinal cord levels. Urodynamic findings were classified as detrusor hyperreflexia (DH), detrusor-external sphincter dyssynergia (DSD), detrusor areflexia/hyporeflexia (DA) or normal. We analyzed the correlation between the neurological spinal level and urodynamic findings. R e s u l t s: Among the 30 patients, 14 patients were revealed DA, 8 were DH, 2 were DSD, and 6 were normal. Of 22 cervicothoracic lesions, 9 had DA, 7 had DH and 2 had DSD, but 4 had normal urodynamic findings. Four lumbar and sacral lesions had DA. Conclusions: The Urodynamic study finding in the lumbosacral lesion revealed DA, but, in those with cervicothoracic lesion are varied including DA, DH, DSD and normal. Urodynamic evaluation may provide more information for management of neurourological dysfunction.