Risk factors of postoperative urinary retention in patients with intradural extramedullary spinal cord tumors

Lysachev D.A., Danilov G.V., Chitadze A.A., Zaitsev A.V., Onoprienko R.A., Zakirov B.A., Brinyuk E.S., Kaprovoy S.V., Poluektov Yu.M., Dzyubanova N.A., Konovalov N.A., Pushkar D.Yu.

1) FSAI N. N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation, Moscow, Russia; 2) Department of Urology of FGBOU VO «Russian University of Medicine» Russian Federation, Moscow, Russia

Objective. Postoperative urinary retention (POUR) is a well-known complication in patients with extramedullary spinal cord tumors and leads to additional complications which are associated with increase in treatment duration and costs.
The goal of current study is to define statistically significant risk factors of POUR in patients with extramedullary spinal cord tumors.
Materials and methods. The data of 221 patients (155 women and 66 men, aged 19 to 84 years) undergoing surgery for extramedullary spinal cord tumors at the N.N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation from January 2019 to December 2022 were evaluated. Of these, 178 patients were included in the prospective analysis, and 43 patients - in the retrospective analysis (based on data obtained from electronic health records). Urological symptoms in patients in the prospective group were assessed by the Center’s urologist before and after neurosurgical intervention. Neurological status and urinary function were assessed by neurologist and urologist using the modified JOA score.
Results. A statistically significant association was established between multiple clinical and topographic-anatomical features of extramedullary tumors and postoperative urinary retention (POUR). Based on the results of multiparametric analysis, an algorithm for stratifying patients according to the risk of developing POUR was proposed.
Conclusion. The conducted study demonstrates the association of POUR with a number of clinical and topographic-anatomical features of extramedullary tumors, which should be taken into account when planning surgical intervention and managing patients in the early postoperative period.

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About the Authors

Corresponding author: D.A. Lysachev – urologist, FSAI N. N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation, Moscow, Russia; e-mail: dlysachev@nsi.ru

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