Evaluación neurourológica continuada en la mielodisplasia

Abstract

OBJECTIVES: Myelodysplasia produces a neurourological lesion with unpredictable urodynamic sequelae. The present study describes our experience in 18 patients with myelodysplasia and vesicourethral dysfunction. METHODS: The study comprised 18 patients (11 males and 7 females) with myelodysplasia and vesicourethral dysfunction. Patient median age was 15.7 years (range 7 months - 57 years) and the mean follow-up was 20 months (range 7 - 47 months). After physical and neurourological examination, all patients underwent a complete urodynamic evaluation, including selective electromyography of the periurethral sphincter and videocystography. The urodynamic studies were repeated regularly during follow-up. RESULTS: 14 patients (67.7%) showed a lower motor neuron vesicourethral dysfunction; 2 (11.1%) had upper motor neuron lesion and 2 (11.1%) mixed motor neuron lesion. During the study period, no alterations were observed in the urodynamic pattern of patients with upper or mixed motor neuron lesions, but 9 patients (64.2%) with lower motor neuron lesions showed changes in the urodynamic pattern compared with the first evaluation, with alterations in bladder compliance being the most frequent. CONCLUSIONS: Alterations in bladder compliance may arise from neurogenic and nonneurogenic factors. Our findings indicate the need for close urodynamic surveillance of patients with myelodysplasia and vesicourethral dysfunction.