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65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

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The influence of skull base chordoma on lower urinary tract symptoms

Meeting Abstract

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  • Reza Akhavan-Sigari - Department of Neurosurgery, University Medical Center Göttingen, Germany
  • Mehdi Abili - Department of Neurosurgery, Mashhad University of Medical Sciences, Mashhad, Iran
  • Veit Rohde - Department of Neurosurgery, University Medical Center Göttingen, Germany
  • H. Tezval - Department of Urology, Hannover Medical School, Hannover, Germany

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocDI.15.03

doi: 10.3205/14dgnc208, urn:nbn:de:0183-14dgnc2086

Published: May 13, 2014

© 2014 Akhavan-Sigari et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Chordoma is a rare malignant bone tumor that originates from the remnants of the embryonic notochord, which normally forms and dissolves during early fetal development. With increasing size, the chordama can reach or even compress the brain stem. The aim of our study is to provide the first insights into the potential role of skull base chordoma, which causes brainstem compression in and around Barrington's nucleus, and its effect on the micturition center.

Method: 22 of 74 patients with skull base chordoma and brainstem compression treated in two hospitals between 1986 and 2007 described voiding difficulties and were given the IPSS questionnaire. These patients underwent urodynamic testing. Follow-up periods ranged from 6 months to 10 years.

Results: 22 (7 women, 15 men) with a median age of 37 years were evaluated with voiding diaries and computer urodynamic investigation. Urodynamic testing revealed detrusor overactivity in 55%, low compliance bladder in 14%, detrusor-sphincter-dyssynergia in 45% and uninhibited sphincter relaxation in 27%. Despite the description of incomplete emptying and urgency, 4 patients had normal urodynamic findings (18%).

Conclusions: Brain stem compression by a chordoma often leads to LUTS, which was not appreciated so far in the neurosurgical literature. The compression of the dorsolateral pons, including pontine reticular nucleus and the reticular formation and the locus coeruleus seems to be mainly responsible for LUTS. Patients with brain stem compressing chordoma should be seen by an urologist before surgery.