VOIDING DYSFUNCTION AND URODYNAMIC FINDINGS IN PATIENTS WITH LUMBAR SPINAL STENOSIS AND THE EFFECT OF DECOMPRESSIVE LAMINECTOMY

Eighteen consecutive patients (12 men and 6 women, mean age 55) with c linically and radiologically verified lumbar spinal stenosis underwent urodynamic examinations before decompressive laminectomy (n = 16) and 15 afterwards. Twelve of the patients (67%) had symptoms of voiding d ysfunction preoperatively but urodynamic findings were normal in most cases only one patient showing detrusor hyperreflexia and one obstruct ion. Three patients reported an improvement in voiding postoperatively . Three patients showed obstructive voiding postoperatively, one under going TURF with a good outcome. One patient developed detrusor areflex ia after the operation, with difficulties in bladder emptying. The onl y statistically significant changes in urodynamic parameters were rise s in the maximum urethral pressure and urethral closure pressure. When considering the radicular symptoms and back pains the overall outcome was assessed as excellent or good in 6 cases, 6 had a fair outcome an d 4 poor. Decompressive laminectomy gives acceptable results but the e ffects on bladder and urethral function remain controversial and unexp ected. Electrophysiological investigations are needed for more detaile d analysis of these cases.