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Disturbances of micturition in patients with a spinal arteriovenous malformation.

Abstract
Neuro-urological studies were performed on 9 patients with a spinal arteriovenous malformation (S-AVM). The micturitional history revealed that all 9 patients had voiding symptoms, obstructive in 9 and irritative in 3 patients. All patients still had obstructive symptoms after treatment of S-AVM. Six of the 9 patients had a large volume of residual urine before treatment; 5 showed urinary retention. Four of the 5 patients (80%) for whom urodynamic studies were performed before treatment had micturitional dysfunction; 2 patients had detrusor hyperreflexia, 1 with detrusor external urethral sphincter dyssynergia (DSD) and 1 with a normal sphincter, 1 patient had an autonomous bladder with DSD and 1 patient had an atonic bladder with DSD. Only 1 patient had a normal bladder and sphincter. Findings of the urodynamic studies after treatment in 9 patients showed detrusor hyperreflexia in 3 patients (2 with DSD and 1 with normal sphincter), autonomous bladder in 1 patient with DSD, atonic bladder in 4 patients (2 with DSD, 1 with incompetent sphincter and 1 with normal sphincter) and normal bladder with normal sphincter in 1 patient. Lower urinary function after treatment of S-AVM was improved in 2 patients, unchanged in 4 patients and worsened in 3 patients. The above results showed 80% of S-AVM had a severe neuropathic bladder manifested mainly by disturbance of micturition. Treatment of S-AVM does not necessarily improve the lower urinary tract function.
AuthorsN Murayama, K Yasuda, T Yamanishi, T Hattori, H Kitahara, J Shimazaki
JournalParaplegia (Paraplegia) Vol. 27 Issue 3 Pg. 212-6 (Jun 1989) ISSN: 0031-1758 [Print] England
PMID2762008 (Publication Type: Comparative Study, Journal Article)
Topics
  • Adult
  • Aged
  • Arteriovenous Malformations (complications, physiopathology, therapy)
  • Electromyography
  • Female
  • Humans
  • Leg (physiopathology)
  • Male
  • Middle Aged
  • Spinal Cord (blood supply)
  • Urethra (physiopathology)
  • Urination
  • Urination Disorders (etiology, physiopathology)
  • Urodynamics

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