Mp59-11 Neurologic Diagnoses Are Prevalent in Subspecialty Chronic Pelvic Pain Referrals

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Basic Research Combination of bladder, bowel, sexual or pain symptoms referable to the lower spine; Pain within a dermatome referable to a specific nerve/root; Balance/gait alteration; Abnormal reflexes; Upper motor neuron (UMN) findings on urodynamics or some cases of hypotonic bladder; History suggesting neurologic contributor; Multiple autonomic symptoms; Chronic overlapping pain syndromes. Subsequent workup was tailored to the neurological evaluation and presenting complaints, including video urodynamic testing, magnetic resonance imaging (MRI), laboratory testing, electromyography (EMG), autonomic testing, and skin biopsy for SFN. RESULTS: 187 patients underwent combined evaluation. 96% underwent formal neurological examination: 45 had UMN findings, 16 lower motor neuron findings, and 103 nonfocal examinations. 73 were evaluated via EMG, 38 by skin biopsy, 108 with MRI, and 79 with laboratory studies. 75 (40%) are still undergoing workup. Of 113 patients who have completed evaluation, 75 (66%) were confirmed to have a neurologic diagnosis and 38 had an unremarkable workup. Most common neurologic diagnoses included SFN, large fiber neuropathy, severe spinal stenosis, and lumbosacral radiculopathy (Table 1). CONCLUSIONS: Neurologic disease is prevalent, present in 66% of subspecialty chronic pelvic pain patients who screen positive for neurologic symptoms. Most of the diagnoses in this study were de novo and patients had experienced diagnostic delay for up to years. Screening for neurological conditions is recommended in urologic and gynecologic patients with CPP to facilitate appropriate diagnosis and management. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e961 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Dyer Pettijohn More articles by this author Charles E. Argoff More articles by this author Elise J. B. De More articles by this author Expand All Advertisement PDF downloadLoading ...