Neurological Surgery No Shinkei Geka Volume 39, Issue 10 (October 2011)

Lumbar Canal Stenosis with Overactive Bladder Presenting Urinary Incontinence Developed by Walking: A Case Report Kazuyoshi YAMAZAKI 1 , Daijiro MORIMOTO 1 , Toyohiko ISU 1 , Tetsuaki IMAI 1 , Ryouji MATSUMOTO 1 , Masanori ISOBE 1 , Narumi TANIGUCHI 2 1Department of Neurosurgery,Kushiro Rosai Hospital 2Department of Urology,Kushiro City General Hospital Keyword: lumbar canal stenosis , overactive bladder , urinary incontinence pp.983-988
Published Date 2011/10/10
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 A 74-year-old male complained of lower back pain,paresthesia of the bilateral feet and urinary incontinence. Urinary incontinence manifested at rest and worsened with walking. He had a history of surgery for prostatic cancer. Lumbar magnetic resonance imaging (MRI) demonstrated lumbar canal stenosis at the L4/5 level. The investigations including a cystometrogram manifested an overactive bladder caused by lumbar canal stenosis. His clinical symptoms were unresponsive to conservative treatment and posterior decompression at the L4/5 level was performed surgically to treat lumbar canal stenosis. Postoperatively,his symptoms were relieved. Overactive bladder presenting urinary incontinence that deteriorates with walking due to lumbar canal stenosis is suspected of being caused by circulatory disturbance of the cauda equine or conus medullaris. Emergency treatment including surgery is required for urinary retention in patients with lumbar canal stenosis; however,some degree of urinary disturbance may persist even after prompt and adequate surgery. Overactive bladder such as the present case should be considered as a possible symptom of lumbar canal stenosis,and surgical treatment for lumbar canal stenosis may be considered in the ‘overactive bladder’ stage before urinary retention begins,if the patient does not respond to conservative treatment.

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Neurological Surgery 脳神経外科
39巻10号 (2011年10月)
電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院