Management of patients with voiding dysfunction in the early postoperative period after removal of 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) N.N. Burdenko National Medical Research Center for Neurosurgery, Ministry of Health of Russia, Moscow, Russia; 2) Department of Urology, Russian University of Medicine, Ministry of Health of Russia, Moscow, Russia

Introduction. The early postoperative period after surgical intervention for extramedullary spinal cord tumors is critical for the recovery of neurological function, including voiding function. Inadequate diagnosis and treatment lead to secondary complications associated with delayed recovery and increased treatment costs. At this stage, the supportive role of a urologist familiar with the basic principles of neurosurgery and neurourology is important for choosing an individualized strategy for treatment and rehabilitation of voiding function, taking into account tumor size, histology, and location, as well as other risk factors.
Materials and methods. The data of 221 patients (155 women and 66 men; age range, 19 to 84 years) who underwent surgery for extramedullary spinal cord tumors at the N.N. Burdenko National Medical Research Center for Neurosurgery, Ministry of Health of Russia, from January 2019 to December 2022 were analyzed. Of these, 178 patients were included in the prospective analysis and 43 patients in the retrospective analysis based on medical record data. In the prospective group, urinary symptoms were assessed by a urologist of the Center before and after neurosurgical intervention. Neurological syndrome and voiding function were evaluated by a neurologist and a urologist of the department using the modified mJOA scale.
Results. The significant differences in changes in voiding function, according to mJOA scores, after neurosurgical interventions in patients with and without urological follow-up were observed. Urological supervision allowed to assess baseline voiding function and the functional outcomes of surgical treatment of extramedullary spinal cord tumors more objectively.
Conclusion. Urological support of patients with extramedullary spinal cord tumors in the perioperative period allows objective and detailed monitoring of the clinical course, both neurological and urological, which is important for a clearer understanding of the functional outcomes of neurosurgical treatment.

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About the Authors

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

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