Fidas A, MacDonald H L, Elton R A, McInnes A, Wild S R, Chisholm G D
Western General Hospital, Edinburgh.
BMJ. 1989 Feb 11;298(6670):357-9. doi: 10.1136/bmj.298.6670.357.
To determine the relation between neurophysiological abnormalities and the radiological detection of spina bifida occulta in patients with dysfunction of the lower urinary tract.
Blind assessment and subsequent decoding of mixed batch of abdominal radiographs from patients with and without urological symptoms for evidence of spina bifida occulta and comparison of results with those of previous control series.
Review study among tertiary referrals to an incontinence clinic of a city hospital.
One hundred and thirty eight adults with proved urodynamic abnormalities in whom neurophysiological measurements were available.
None.
Correlation of neurophysiological abnormalities in lower urinary tract dysfunction with presence and type of spina bifida occulta and level of opening of posterior sacral arcs.
On decoding radiographs those from patients without urological symptoms showed a similar prevalence of spina bifida occulta to that in the control series (631/2707 controls; 23%). By contrast, patients with urological symptoms had a significantly increased prevalence of spina bifida occulta at S1 and S2 and a higher level of opening of posterior sacral arcs. The increased prevalence of the bony defect was particularly striking in men with urgency and instability and in women with stress incontinence. No significant correlation was found between any particular neurophysiological abnormality and the presence of spina bifida.
In patients with dysfunction of the lower urinary tract neurophysiological abnormalities may be associated with congenital dysraphic lesions in the lower lumbar spine and sacrum. There appears to be no direct causal relation between the radiological and neurophysiological abnormalities but the findings suggest a common aetiological factor.
确定下尿路功能障碍患者神经生理异常与隐性脊柱裂放射学检测结果之间的关系。
对有或无泌尿系统症状患者的腹部X光片混合批次进行盲法评估及后续解读，以寻找隐性脊柱裂的证据，并将结果与之前的对照系列进行比较。
一家城市医院尿失禁诊所对三级转诊患者的回顾性研究。
138名已证实存在尿动力学异常且有神经生理学测量数据的成年人。
无。
下尿路功能障碍的神经生理异常与隐性脊柱裂的存在、类型以及骶后弓开口水平之间的相关性。
解读X光片时发现，无泌尿系统症状患者的隐性脊柱裂患病率与对照系列相似（2707名对照者中有631例，占23%）。相比之下，有泌尿系统症状的患者在S1和S2水平隐性脊柱裂的患病率显著增加，骶后弓开口水平更高。骨缺损患病率的增加在伴有尿急和不稳定症状的男性以及压力性尿失禁的女性中尤为明显。未发现任何特定神经生理异常与隐性脊柱裂的存在之间存在显著相关性。
在下尿路功能障碍患者中，神经生理异常可能与下腰椎和骶骨的先天性神经管闭合不全病变有关。放射学异常与神经生理异常之间似乎没有直接因果关系，但研究结果提示存在共同的病因学因素。
