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Neurogenic urinary disorders in patients with tuberculous spondylitis before and after surgical treatment

ABSTRACT: Tuberculosis inflammation of vertebral column (spondylitis) can lead to neurogenic lower urinary tract dysfunction. There is lack of available publications for neurogenic lower urinary tract dysfunction in spinal tuberculosis. OBJECTIVE: To evaluate urodynamic disturbances in spinal tuberculosis before and after surgery for spondylitis. MATERIALS AND METHODS: We observed 19 patients with spinal tuberculosis, who had symptoms of micturition’s impairment. 14 patients (73,6%) were male and 5 (26,4%) were female, average age was 43,7 ± 7,9 years (27–66). Control evaluation was performed after surgery on day 21–28. RESULTS: Before surgery we found detrusor overactivity in 11 (57,9%) patients and 2 of those with detrusor overactivity had detrusor-sphincter dyssynergia. Detrusor hypo-/acontractility was diagnosed in 8 (42,1%). After surgery 5 patients (26,3%) exhibited improvement, in one case urodynamic disturbances were resolved. One patient developed detrusor overactivity and incontinence de novo and one patient had worsening neurological status, loss of sensitivity and acontractile bladder. CONCLUSION: Variable lower urinary tract dysfunction can be diagnosed in spinal tuberculosis. Only 26,3% of patients have improvement after surgery. New conditions or worsening of previous neurogenic lower urinary tract dysfunctions can be observed.