Refractory lower urinary tract symptoms in patients with lumbar disc hernia relieved by non-surgical treatment

World J Urol. 2021 May;39(5):1597-1605. doi: 10.1007/s00345-020-03330-9. Epub 2020 Jul 1.

Abstract

Purpose: Refractory lower urinary tract symptoms (LUTS) coexisting with lumbar disc hernia (LDH) have been shown to resolve following LDH surgery, implying that LDH causes these LUTS. The purpose of this study was to report outcomes in patients with refractory LUTS and LDH following non-surgical treatment targeting LDH.

Methods: A retrospective cohort study was conducted using outpatient data collected at Tongji Hospital, China, between 2016 and 2018. This study included 131 adult patients with refractory LUTS and LDH. Patients were stratified into two groups. Group A underwent non-surgical treatment for LDH plus pharmacological treatment for LUTS. Group B underwent only pharmacological treatment for LUTS. The International Prostate Symptom Score (IPSS), the IPSS quality of life (QoL) score, and uroflowmetry were used to evaluate outcomes.

Results: In group A, following treatment, the maximum flow rate (Qmax) increased by 3.92 ml/s (p < 0.001), the IPSS reduced by 5.99 points (p < 0.001), and the QoL score decreased by 1.51 points (p < 0.001). In group B, the Qmax increased by 0.09 ml/s (p = 0.833), the IPSS reduced by 0.72 points (p = 0.163), and the QoL score decreased by 0.07 points (p = 0.784).

Conclusions: LUTS can be relieved by a combination of pharmacological treatment for LUTS and non-surgical treatment for LDH in some refractory LUTS patients with LDH. MRI is recommended for these patients.

Keywords: Conservative treatment; Intervertebral disc degeneration; Lower urinary tract symptoms; Magnetic resonance imaging; Urodynamics.

MeSH terms

  • Adult
  • Cohort Studies
  • Female
  • Humans
  • Intervertebral Disc Displacement / complications*
  • Intervertebral Disc Displacement / therapy*
  • Lower Urinary Tract Symptoms / etiology*
  • Lumbar Vertebrae*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome