The connection between frontal lobe brain tumors and lower urinary tract symptoms – Series of 347 patients

R. Akhavan-Sigari, P. Mortzavi-Zadeh, L. Trakolis, H. Keyhan, B. Amend, S. Herlan

Department of Neurosurgery, University Medical Center, Tuebingen, Germany. reza.akhavan-sigari@med.uni-tuebingen.de

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• Urology

OBJECTIVE: The present study aimed to provide an early insight into the effect of intra-axial frontal lobe tumors on the micturition center and its potential role in producing compression in and around the prefrontal cortex.

PATIENTS AND METHODS: A total of 149 symptomatic patients were selected for urodynamic testing. The study sample included all patients with intra-axial frontal lobe tumors treated at two locations: the University Medical Center Tuebingen (Germany), and Azad University of Medical Sciences (Iran) between 2017 and 2020. Lower urinary tract symptoms (LUTS) were recorded in patients with frontal lobe compression due to local tumor growth. The symptomatic patients had brain magnetic resonance (MRI) images taken to examine for possible lesions.

RESULTS: The treated patients (149 patients with a median age of 55 years) were evaluated using computer urodynamic investigation and voiding diaries. The results of urodynamic testing of 149 symptomatic patients showed detrusor over-activity in 82 (55%) patients, dyssynergia of detrusor-sphincter in 67 (45%) patients, uninhibited sphincter relaxation in 40 (27%) patients, and low-compliance bladder in 21 (14%) patients. There was no significant correlation found between tumor size and urinary symptoms (p = 0.103, Spearman q = 0.826).

CONCLUSIONS: Frontal intra-axial tumors compressing and infiltrating the prefrontal cortex influence the micturition center and produce lower urinary tract symptoms. The tumors of the right frontal lobe were directly associated with incontinence, which was completely disappeared in 70% of the patients within 2 years.

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