UROLOGICAL SYMPTOMATOLOGY IN PATIENTS WITH REFLEX SYMPATHETIC DYSTROPHY

Purpose: We determined the effect of reflex sympathetic dystrophy on l ower urinary tract function. Materials and Methods: A total of 20 cons ecutive patients (16 women and 4 men) with neurologically verified ref lex sympathetic dystrophy was referred for voiding symptoms, including urgency, frequency, incontinence and urinary retention. No patient ha d had voiding symptoms before the initial trauma that induced reflex s ympathetic dystrophy. Evaluation included medical history, physical ex amination, video urodynamic testing and cystoscopy. Results: Mean pati ent age was 43.4 +/- 10.2 years (range 28 to 58) and mean duration of urological symptoms was 4.9 +/- 3.6 years (range 1 to 14). Urodynamic study demonstrated a mean cystometric bladder capacity of 417 +/- 182 ml. (range 120 to 700). The urodynamic diagnoses included detrusor hyp erreflexia in 8 patients, detrusor areflexia in 8, sensory urgency in 3 and detrusor hyperreflexia with detrusor-external sphincter dyssyner gia in 1. In 4 women genuine stress urinary incontinence was also docu mented urodynamically. Conclusions: Reflex sympathetic dystrophy may h ave a profound effect on detrusor and sphincter function.