Abstract: PD64-12
Sources of Funding: none

Introduction

With advancement of treatment modalities, the survival of patients with brain tumor has been increased, and the management of lower urinary tract symptom of brain tumor patients emerged as a new challenge. Although several brain imaging studies have been introduced with healthy brain parenchyma, identifying fundamental brain region involved, the correlation of each areas is not proved distinctively. Especially, the effect of intracranial space occupying lesions on bladder and urethra is not clearly demonstrated until now. We have evaluated urological symptoms and urodynamic findings of patients with brain tumor, and made comparison of the urodynamic patterns according the affected brain areas.

Methods

Brain tumor patients with urological symptom who received urodynamic test at our tertiary referral center from May 2007 to March 2016 were evaluated. To minimize confounding variables, patients with accompanying degenerative neurological disorders, spinal cord injury, diabetes mellitus, prostatic hyperplasia, history of pelvic organ surgery were excluded. And patients with multiple brain lesions were also excluded. The localization of brain tumor was based on the magnetic resonance imaging or computed tomography imaging taken same time of urodynamic study.

Results

Finally, twenty six patients (male 8 female 18) were assessed. The median age at urodynamic study was 46.5 (21.3~76.5) years old. Twenty four patients received urodynamic study at median period of 3.6 (0.9~74.3) months after brain surgery, and two patients had not received operation at the time of urodynamic study. Involuntary detrusor contraction was observed in 13 (50%) patients, acontractile detrusor was observed in 7 (36.9%) patients, and detrusor sphincter dyssynergia was observed only in one patient with frontal lobe tumor. The urological symptom and urodynamic findings showed different pattern according to the affected territory (Figure 1.)

Conclusions

We could observe diverse urodynamic patterns according the affected areas. Our results suggest complexity of micturition circuit in central nervous system. Further study with large cohort in correlation with functional brain imaging might solve the mysterious role of brain on bladder, suggesting management guide according to the affected brain area.

Funding

none