Radiology, Vol 185, 113-117, Copyright © 1992 by Radiological Society of North America
Distention of the posterior urethra: association with nonneurogenic neurogenic bladder (Hinman syndrome)
JF Johnson 3d, RJ Hedden, ML Piccolello and J Wacksman
Department of Radiology, Children's Hospital Medical Center, Cincinnati, OH 45229-2899.
In nonneurogenic neurogenic bladder (NNNB), or Hinman syndrome, a
functional bladder outlet obstruction is produced by voluntary contraction
of the external sphincter during voiding. To determine whether any
radiographic findings are diagnostic of this condition, the authors
reviewed the genitourinary images of six boys in whom NNNB was diagnosed in
the past 5 years. In contrast to true neurogenic bladder, findings of
elongated, trabeculated, high-volume bladders with substantial postvoid
residuals, obstructive uropathy, and vesicoureteral reflux were not
associated with clinical, radiographic, or urodynamic evidence of an
underlying neurologic abnormality. Furthermore, four boys had distention of
the posterior urethra that the authors believe is suggestive of this
condition. In these patients, the posterior urethra appeared entirely
normal during early voiding, but distended after contraction of the
external sphincter as voiding progressed. This posterior urethral
distention may worsen the symptoms of enuresis, but may also reduce or
retard the damage to the proximal urinary tract.
