Lower urinary tract symptoms in women with spinal pathologies: a prospective prevalence study
Raffee S, Griffin M, Massie L, Basheer A, Tundo K, Brown A, Air E, and Atiemo H. Lower urinary tract symptoms in women with spinal pathologies: a prospective prevalence study. Neurourology and Urodynamics 2020; 39:S198-S199.
Neurourology and Urodynamics
Introduction: The relationship between spinal pathologies and lower urinary tract symptoms (LUTS) is largely unknown. The incidence of LUTS in patients with lumbar disk disease has been estimated to be between 27% and 92%. Further, the effect of spine surgery on lower urinary tract symptoms has not been definitively established.
The objective of this study was to determine the prevalence of urinary dysfunction among female patients with spinal pathologies and to evaluate the effects of spinal surgery on these symptoms using validated questionnaires. Methods: After IRB approval, women with lower spine complaints were identified in the neurosurgery clinic. Patients were asked to fill out the Pelvic Floor Distress Inventory (PFDI‐20) and Pelvic Floor Impact Questionnaire (PFIQ‐7) at their initial visit. Exclusion criteria included primary spinal pathology in the cervical spine. If the patient elected to undergo spine surgery after their initial evaluation, questionnaires were obtained at 6 weeks and 6 months postoperatively. Patient demographics, medical and surgical history were obtained through a review of the electronic medical record. Results: A total of 169 patients were recruited between April 2017 and July 2019. See Table 1. At baseline, 72.7% answered “yes” to at least one question on the Urinary Distress Inventory (UDI‐6). The average score was 23.5/100. Those with higher UDI‐6 scores were strongly correlated to higher Urinary Impact Questionnaire (UIQ‐7) score (Pearson correlation coefficient= 0.69). Colorectal‐Anal Distress Inventory (CRADI‐8) was also evaluated with 64.3% presenting with some level of bowel complaints. The average score was only 14.4/100. Higher baseline UDI‐6 and CRADI‐8 scores were observed for patients with a history of a prior hysterectomy, use of stool softeners, and a spinal pathology including L3 (P < 0.05). Postoperative questionnaires were obtained from 22 women at 6 weeks and 8 women at 6 months, with the average UDI‐6 scores being 19.9/100 and 31.2/100, respectively. Conclusion: Though the majority of women presented with some level of urinary bother, quality of life impact appeared low. More significant bother was seen in patients that had L3 spinal involvement at their initial assessment. At this point, there was no demonstrable influence of surgery on urinary symptoms, though the number of patients followed postoperatively was small.