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腰椎管狭窄症的神经泌尿后遗症

Neuro-urological sequelae of lumbar spinal stenosis.

作者信息

Gandhi Jason, Shah Janki, Joshi Gargi, Vatsia Sohrab, DiMatteo Andrew, Joshi Gunjan, Smith Noel L, Khan Sardar Ali

机构信息

a Department of Physiology and Biophysics , Stony Brook University School of Medicine , Stony Brook , NY , USA.

b Medical Student Research Institute , St. George's University School of Medicine , Grenada , West Indies.

出版信息

Int J Neurosci. 2018 Jun;128(6):554-562. doi: 10.1080/00207454.2017.1400973. Epub 2017 Dec 4.

Abstract

PURPOSE

Lumbar spinal stenosis is characterized by the narrowing of the spinal canal, which subsequently induces impingement of neural elements in the lumbar spine. Thus, symptoms of lumbar spinal stenosis are typically associated with damage to those neural elements. Herewith, we target the genitourinary symptoms of lumbar spinal stenosis and the importance of differentiating these symptoms from other genitourinary pathologies, namely benign prostatic hyperplasia.

MATERIALS AND METHODS

MeSH and keywords relevant to lumbar spinal stenosis and the organs of the urinary tract were used to a guide a literature search on MEDLINE.

RESULTS

Bladder dysfunction, lower urinary tract symptoms (e.g. urinary incontinence, detrusor overactivity and underactivity, as well as frequent urinary tract infections), renal osteodystrophy and sexual dysfunction (e.g. erectile dysfunction and priapism) are implicated in lumbar spinal stenosis.

CONCLUSIONS

It is imperative for urologists to conduct a thorough history and physical examination so that they will not misdiagnose secondary genitourinary manifestations of lumbar spinal stenosis as primary problems or misunderstand secondary problems. Urological consultations are also integral to prioritizing patients with the highest risk of bladder damage for corrective spinal surgery.

摘要

目的

腰椎管狭窄症的特征是椎管狭窄,进而导致腰椎神经组织受到压迫。因此,腰椎管狭窄症的症状通常与这些神经组织的损伤有关。在此,我们关注腰椎管狭窄症的泌尿生殖系统症状,以及将这些症状与其他泌尿生殖系统疾病(即良性前列腺增生)相鉴别的重要性。

材料与方法

使用与腰椎管狭窄症及泌尿系统器官相关的医学主题词(MeSH)和关键词,在医学文献数据库(MEDLINE)上指导文献检索。

结果

膀胱功能障碍、下尿路症状(如尿失禁、逼尿肌过度活动和活动不足,以及频繁的尿路感染)、肾性骨营养不良和性功能障碍(如勃起功能障碍和阴茎异常勃起)与腰椎管狭窄症有关。

结论

泌尿外科医生必须进行全面的病史询问和体格检查,以免将腰椎管狭窄症的继发性泌尿生殖系统表现误诊为原发性问题,或误解继发性问题。泌尿外科会诊对于将膀胱损伤风险最高的患者列为脊柱矫正手术的优先对象也至关重要。

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