Cauda equina syndrome: False-positive diagnosis of neurogenic bladder can be reduced by multichannel urodynamic study
European Spine Journal Jan 14, 2020
Kalidindi KKV, et al. - Because the present consensus implies urgent surgical decompression if clinical characteristics of cauda equina syndrome (CES) are supported by MRI evidence of pressure on cauda equina. Nevertheless, the clinical diagnosis has a high false-positive rate and MRI is a poor indicator. Investigators sought to assess the ability of an objective urological assessment protocol utilizing uroflowmetry + USG-PVR as a screening test and invasive urodynamic studies (UDS) as a confirmatory test in people with suspected CES to figure out neurological impairment of the bladder function. They performed a retrospective study on people with equivocal findings of cauda equina syndrome from January 2014 to December 2018 with positive MRI findings. In a total of 249 individuals who fulfilled the inclusion standards, 34 people were had normal uroflowmetry and USG-PVR findings and 211 people who undergo invasive UDS. Overall, to definitively establish the neurovesical involvement in CES, multichannel UDS gives an objective diagnostic tool. Moreover, to avoid the possibility of a false-positive diagnosis of CES they used multichannel UDS as an adjunct to clinical findings.Go to Original
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