Clinical significance of gender‑specific urodynamic investigation in evaluating bladder functional recovery in patients with lumbar intervertebral disc prolapse

Sultan Uddin; Sayeed Uz Zaman Amir Al Asad; Mohammad Imarat Hossain; Shaikh Imran Mohammad; Monika Das; Rashed Mizan; Saurov Das; Saikat Joydhar; A. T. M. Aman Ullah

doi:10.18203/2349-2902.isj20261990

Authors

Sultan Uddin Department of Urology, National Institute of Traumatology and Orthopedic Rehabilitation, Dhaka, Bangladesh
Sayeed Uz Zaman Amir Al Asad Department of Surgery, Rajshahi Medical College Hospital, Rajshahi, Bangladesh
Mohammad Imarat Hossain Department of Surgery, Kurmitola General Hospital, Dhaka, Bangladesh
Shaikh Imran Mohammad Department of Urology, Khulna Medical College Hospital, Khulna, Bangladesh
Monika Das Department of Urology, Bangladesh Medical University, Dhaka, Bangladesh
Rashed Mizan Department of Urology, Bangladesh Medical University, Dhaka, Bangladesh
Saurov Das Department of Urology, Bangladesh Medical University, Dhaka, Bangladesh
Saikat Joydhar Department of Urology, Bangladesh Medical University, Dhaka, Bangladesh
A. T. M. Aman Ullah Department of Urology, Bangladesh Medical University, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2349-2902.isj20261990

Keywords:

Lumbar intervertebral disc prolapse, Urodynamic study, Gender difference, Bladder functional recovery, Neurogenic bladder, Decompression surgery

Abstract

Background: Lumbar intervertebral disc prolapse (LDP) frequently causes neurogenic bladder dysfunction due to sacral root compression. Urodynamic investigation is the gold standard for assessment, but the influence of gender on bladder functional recovery after decompression surgery remains unclear. Objectives were to evaluate the clinical significance of gender-specific urodynamic investigation in assessing bladder functional recovery after lumbar decompression surgery in patients with LDP.

Methods: This prospective longitudinal study included 30 patients (20 males, 10 females) with LDP who underwent microdiscectomy. Urodynamic parameters-maximum cystometric capacity (MCC), post-void residual urine (PVR), maximum detrusor pressure (Pdetmax), bladder compliance (BC), and maximum flow rate (Qmax)-were measured preoperatively and three months postoperatively. Gender-specific changes were analysed using paired t test, Wilcoxon signed-rank test, and McNemar-Bowker test.

Results: Preoperative urodynamic abnormalities were present in 73.3% of patients, with no significant gender differences at baseline. In males, significant improvements were observed in MCC (+14.95 ml, p=0.009), PVR (-16.06 ml, p<0.001), and Qmax (+4.90 ml/s, p<0.001). In females, only PVR showed a significant reduction (-54.86 ml, p=0.001). Overall, urodynamic normalisation occurred in 18.8% of males but in none of the females. Detrusor overactivity resolved in 25% of males versus 0% of females.

Conclusions: Gender significantly influences urodynamic recovery following lumbar decompression for LDP. Males attain more extensive and pronounced improvements, whereas females demonstrate limited recovery. Gender-specific urodynamic assessment is of considerable clinical importance for prognostication and personalized rehabilitation.

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