VALUE OF MAGNETIC-RESONANCE-IMAGING OF THE LUMBOSACRAL SPINAL-CORD INPATIENTS WITH VOIDING DYSFUNCTION

Purpose: We evaluated the role of magnetic resonance imaging (MRI) of the lumbosacral spinal cord in patients with voiding complaints and ab normal urodynamic findings but normal neurological and lower spine exa minations. Materials and Methods: We studied 17 women and 13 men 17 to 50 years old (mean age 32.2) who presented with voiding complaints. A ll patients had a completely normal neurological examination and no ev idence of prostatic enlargement.; Of the 30 patients 18 had incontinen ce (17 urge, and 1 stress and urge), 9 frequency and urgency alone, an d 3 urinary retention. Seven patients had persistent enuresis (2 prima ry and 5 secondary). All 30 patients underwent multichannel urodynamic s and MRI of the lower spinal cord. Results: On urodynamic testing, 25 patients had bladder instability, 3 a hypocontractile or weak detruso r, 1 significantly decreased sensation only and 1 stress incontinence. No patient had detrusor external sphincter dyssynergia or outflow obs truction. 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 findi ngs, with normal neurological and lower spine examinations, the value of MRI of the lumbosacral spine is limited.