[Functional participation of the T10-L2 sympathetic component in inferior urinary tract dynamics].

OBJECTIVES: To analyze the effect of injury of the sympathetic element of vesico-urethral innervation on lower urinary tract.

METHODS: We studied clinical, urodynamic, and radiological features in a sample of 261 patients studied because of neurogenic vesico-urethral dysfunction. Three types of inferior sympathetic lesions were established based on urodynamic and radiologic behaviors. We studied relationships between this kind of lesions and clinical, urodynamic, and radiological features, as well as the association of lower sympathetic lesions with the rest of vesicourethral innervation elements. Results were analyzed by logistic regression, and linear multivariate regression, controlling for urodynamic factors, age, sex, and different neurological diagnosis.

RESULTS: 95 patients were diagnosed of lower sympathetic lesions. This type of lesions were observed in relation to congenital pathology, being more frequent in boys. These lesions were related with urinary incontinence and vesicoureteral reflux. Lesions producing bladder dynamics disturbances had a higher location than those responsible for bladder neck incompetence development.

CONCLUSIONS: Vesicourethral sympathetic innervation lesion of the lower motor neuron type is related to urinary incontinence and vesicoureteral reflux, being bladder neck complex incompetence a determinant factor in both circumstances. This kind of lesions could be a group of different types, with location in different parts of the central and peripheral nervous system that produce very different vesicourethral behaviors.