Diagnosis and treatment of patients with neurogenic bladder caused by sacral nerve root lesions

Objective To investigate the clinical and pathological features of sacral nerve root lesions and the diagnosis and treatment for these clinical entities. Methods The clinical data of the patients with urine retention or refractory lower urinary tract symptoms (LUTS) caused by sacral nerve root lesions were retrospectively analyzed. Totally 27 patients were included in this study, including 4 cases of acute retention, 6 chronic retention and 17 refractory LUTS. All patients had urodynamic disorders and sacral nerve root space-occupying lesions demonstrated by magnetic resonance imaging. All the patients received surgical treatment and were followed up one year or more. Results The pathological findings included simple cyst in 3 cases, ganglioneuroma in 5, cyst wall inflammation in 15, cyst wall hyaline degeneration in 15, and neurodegeneration in 15. Postoperatively, 9 of the 10 patients with retention could voluntarily void and 1 remained suprapubic catheter drainage. All 17 patients with refractory LUTS improved significantly in terms of international prostate symptom score, visual analogue scale pain score, quality of life, maximal urinary flow rate and post void residual (P<0.01). Conclusions Sacral nerve root lesions can be the causes of urinary retention or refractory LUTS. Surgical treatment can improve patient's voiding function and quality of life. Key words: Sacral nerve root lesions; Urinary retention; Lower urinary tract symptoms; Pelvis pain; Neurogenic bladder