Publication:

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

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.