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Huang M, Zheng H, Huang T, Yang X, Liu Q, Li Q, Tang P, Xie K, Chen H. Intravesical injection of botulinum toxin type a may be an effective treatment option for autonomic dysreflexia in patients with high-level spinal cord injury. J Spinal Cord Med 2024; 47:74-78. [PMID: 36269317 PMCID: PMC10795643 DOI: 10.1080/10790268.2022.2135230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVE To evaluate the efficacy of intravesical injection of botulinum toxin type A (BTX-A) for neurogenic detrusor overactivity (DO) in reducing the frequency and severity of autonomic dysreflexia (AD). DESIGN A cross-sectional nonrandomized trial with before (baseline) and after (follow-up) assessments. SETTING A single spinal cord injury (SCI) rehabilitation center in China. PARTICIPANTS Twenty-five patients with SCI at or above T6 and a history of AD who underwent urodynamic studies (UDS) before and 3 months after BTX-A injection. INTERVENTIONS Received bladder injection treatment wtih 200 U BTX-A. OUTCOME MEASURES The maximum detrusor pressure(Pdetmax) and voume at first DO(VFIDC), baseline and overall maximum systolic blood pressure (SBP) during UDS, and scores of Incontinence Specific Quality of Life Instrument (IQoL) were recorded before and 3 months after the injection. The change in SBP (ΔSBP) from baseline to maximum SBP during UDS was calculated to assess the severity. The frequency of AD was recorded using ambulatory blood pressure monitoring during a 24 h period before and 3 months after the injection. RESULTS BTX-A injection decreased the Pdetmax and increased the VFIDC and mean urine volume per catheterization increased. The maximum SBP and the ΔSBP during UDS decreased significantly decreased after the injection (151.44 ± 13.92 vs 133.32 ± 9.20 mmHg and 49.44 ± 12.81 vs 33.08 ± 9.11 mmHg respectively, P < 0.05). The frequency of bladder-related ADs (i.e. performed a clean intermittent catheterization or leakage) during a 24-h period significantly decreased from 11.04 ± 1.81-7.88 ± 2.15 (P < 0.001). CONCLUSIONS BTX-A decreases the severity of SBP increase and the number of AD episodes 3 months after intravesical injection.
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Affiliation(s)
- Maping Huang
- Department of Urology, Guangdong Provincial Work Injury Rehabilitation Hospital, Guangzhou, People’s Republic of China
| | - Heyi Zheng
- Department of Traumatic Brain Injury Rehabilitation, Guangdong Provincial Work Injury Rehabilitation Hospital, Guangzhou, People’s Republic of China
| | - Tianhai Huang
- Department of Urology, Guangdong Provincial Work Injury Rehabilitation Hospital, Guangzhou, People’s Republic of China
| | - Xiaoyi Yang
- Department of Urology, Guangdong Provincial Work Injury Rehabilitation Hospital, Guangzhou, People’s Republic of China
| | - Qiuling Liu
- Department of Urology, Guangdong Provincial Work Injury Rehabilitation Hospital, Guangzhou, People’s Republic of China
| | - Qingqing Li
- Department of Urology, Guangdong Provincial Work Injury Rehabilitation Hospital, Guangzhou, People’s Republic of China
| | - Ping Tang
- Department of Urology, Guangzhou First People’s Hospital, South China University of Technology, Guangzhou, People’s Republic of China
| | - Keji Xie
- Department of Urology, Guangzhou First People’s Hospital, South China University of Technology, Guangzhou, People’s Republic of China
| | - Hui Chen
- Department of Urology, Guangdong Provincial Work Injury Rehabilitation Hospital, Guangzhou, People’s Republic of China
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El Farhaoui H, El Moudane A, Al Aggari H, Nadir M, Bounouar O, Barki A. Acute urine retention following medullary compression of metastatic breast cancer in the spinal cord: Rare symptomatlogic presentation and management. Radiol Case Rep 2023; 18:3773-3776. [PMID: 37649722 PMCID: PMC10462783 DOI: 10.1016/j.radcr.2023.07.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 07/19/2023] [Accepted: 07/22/2023] [Indexed: 09/01/2023] Open
Abstract
The management of locally advanced and metastatic breast cancer has evolved since 2021, with confirmation of the role of cell cycle inhibitors. The discovery of breast cancer is often the result of self-examination through the discovery of a nodule, but may also be due to symptoms at the metastatic site. The spinal cord is one of the rare sites of metastatic breast cancer involvement. We report the management of a rare case of metastatic breast cancer in the spinal cord, discovered following acute urinary retention.
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Affiliation(s)
- Hammou El Farhaoui
- Department of Urology, Centre Hospitalier Universitaire Mohammed VI, Faculté de Médecine et de Pharmacie-Oujda, Morocco
| | - Anouar El Moudane
- Department of Urology, Centre Hospitalier Universitaire Mohammed VI, Faculté de Médecine et de Pharmacie-Oujda, Morocco
| | - Hanane Al Aggari
- Department of Urology, Centre Hospitalier Universitaire Mohammed VI, Faculté de Médecine et de Pharmacie-Oujda, Morocco
| | - Miry Nadir
- Department of Urology, Centre Hospitalier Universitaire Mohammed VI, Faculté de Médecine et de Pharmacie-Oujda, Morocco
| | - Oualid Bounouar
- Department of Urology, Centre Hospitalier Universitaire Mohammed VI, Faculté de Médecine et de Pharmacie-Oujda, Morocco
| | - Ali Barki
- Department of Urology, Centre Hospitalier Universitaire Mohammed VI, Faculté de Médecine et de Pharmacie-Oujda, Morocco
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Xu L, Fu C, Zhang Q, Xiong F, Peng L, Liang Z, Chen L, He C, Wei Q. Efficacy of biofeedback, repetitive transcranial magnetic stimulation and pelvic floor muscle training for female neurogenic bladder dysfunction after spinal cord injury: a study protocol for a randomised controlled trial. BMJ Open 2020; 10:e034582. [PMID: 32759239 PMCID: PMC7409967 DOI: 10.1136/bmjopen-2019-034582] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 05/14/2020] [Accepted: 06/23/2020] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Neurogenic bladder dysfunction is prevalent in female patients with spinal cord injury (SCI), and previous guidelines have recommended pelvic floor muscle training (PFMT) for first-line conservative treatment. However, the actual regimen of PFMT varies widely and the single treatment does not satisfy the need of some patients. Therefore, this study aims to provide a detailed rationale and methodology for comparing the effectiveness of PFMT, biofeedback and repetitive transcranial magnetic stimulation (rTMS) as adjunct treatments for neurogenic bladder dysfunction. METHODS AND ANALYSIS This trial is a single-centre randomised controlled trial for female patients with urinary incontinence (UI) in phase of chronic SCI. Eligible participants will be randomised to one of four arms: (1) PFMT, (2) PFMT with biofeedback, (3) PFMT and rTMS and (4) PFMT with biofeedback and rTMS. There will be 44 participants in each arm and all the subjects will undergo 20 treatment sessions, five times a week for 4 weeks. The outcomes will be evaluated at 4 weeks, 3 months and 6 months after randomisation. The primary outcome is the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form, and the secondary outcomes include bladder diary, pelvic floor muscle function and the International Spinal Cord Injury Quality of Life Basic Data Set. ETHICS AND DISSEMINATION The Clinical Research and Biomedical Ethics Committee of the West China Hospital, Sichuan University has approved this trial and the approval number is 2019-885. All participants will be provided written informed consent after verification of the eligibility criteria. The results of this study will be accessible in peer-reviewed publications and be presented at academic conferences. TRIAL REGISTRATION NUMBER Chinese Clinical Trial Registry (ChiCTR1900026126).
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Affiliation(s)
- Lin Xu
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China
| | - Chenying Fu
- State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Qing Zhang
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China
| | - Feng Xiong
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China
| | - Lihong Peng
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China
| | - Zejun Liang
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China
| | - Li Chen
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China
| | - Chengqi He
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China
| | - Quan Wei
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China
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Kavanagh A, Baverstock R, Campeau L, Carlson K, Cox A, Hickling D, Nadeau G, Stothers L, Welk B. Canadian Urological Association guideline: Diagnosis, management, and surveillance of neurogenic lower urinary tract dysfunction - Full text. Can Urol Assoc J 2019; 13:E157-E176. [PMID: 30763235 DOI: 10.5489/cuaj.5912] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Alex Kavanagh
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Richard Baverstock
- vesia [Alberta Bladder Centre]; Division of Urology, Department of Surgery, University of Calgary, Calgary, AB, Canada
| | - Lysanne Campeau
- Department of Urology, Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Kevin Carlson
- vesia [Alberta Bladder Centre]; Division of Urology, Department of Surgery, University of Calgary, Calgary, AB, Canada
| | - Ashley Cox
- Department of Urology, Dalhousie University, Halifax, NS, Canada
| | - Duane Hickling
- Division of Urology, Department of Surgery, The Ottawa Hospital, Ottawa, ON, Canada
| | - Genviève Nadeau
- Division of Urology, CIUSSS-Capitale Nationale Université Laval, Quebec City, QC, Canada
| | - Lynn Stothers
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Blayne Welk
- University of Western Ontario, London, ON, Canada
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Wyndaele JJ. The management of neurogenic lower urinary tract dysfunction after spinal cord injury. Nat Rev Urol 2016; 13:705-714. [PMID: 27779229 DOI: 10.1038/nrurol.2016.206] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The management of patients with neurogenic bladder has changed substantially over the past decades. Obtaining balanced lower urinary tract function has become possible in most patients, although, urological complications remain among the most serious complications these patients are likely to have and, even today, these can have a negative effect on quality of life. To this extent, patients with spinal cord injury (SCI) are likely to develop neurogenic bladder, and data are available on most aspects of neurogenic bladder in these patients. Data on physiology and pathophysiology form the basis of our understanding of patients' symptoms, and also provide a basis for the management of these patients. The use of conservative, and/or more invasive treatment measures, their complications and measures to prevent these complications, are all important clinical aspects that merit discussion. Considerable progress has been made in the urological management of patients with SCI over the past decades, but opportunities remain to make diagnosis more accurate and therapy more successful.
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Affiliation(s)
- Jean-Jacques Wyndaele
- University of Antwerp, Antwerp, SIRATE32 GCV, Bredabaan 32, 2930 Brasschaat, Belgium
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Braley-Berthoumieux E, Gamé X, Marque P, de Boissezon X, Rischmann P, Castel-Lacanal E. [Study of the sensitivity of renal ultrasonography as an indirect means of assessing renal function in patients with neurogenic bladder, from a cohort of 103 patients]. Prog Urol 2014; 24:1114-9. [PMID: 25450757 DOI: 10.1016/j.purol.2014.09.044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2014] [Revised: 09/19/2014] [Accepted: 09/22/2014] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The assessment of renal function is essential to follow up the patients with neurogenic bladder. The objective of this study was to determine if renal ultrasonography would both evaluate the morphology of the urinary tract and renal function. METHOD In a retrospective study, all patients followed for neurogenic bladder were included, regardless of their neurological disease. Renal function was estimated by creatinine clearance (Cl24 h), the reference test in neurological patients, the glomerular filtration rate by the MDRD simplified (MDRDs) and CKD-EPI creatinine formula, and we identified renal abnormalities detected on ultrasonography. RESULTS One hundred and three patients were included (57 men-36 women), mean age 51±13 years. Fifty-nine patients had multiple sclerosis, 23 spinal cord injury. Depending on the method used (Cl24h, MDRDs, CKD-EPI creatinine) respectively 54, 49 and 39 patients had abnormal renal function; eleven patients had abnormal findings on renal ultrasonography. The sensitivity of ultrasonography as an indirect indicator of renal function depending on the method used (Cl24h, MDRDs, CKD-EPI creatinine) was equal respectively to 14%, 8% and 10%. CONCLUSION Renal ultrasonography, which is essential to follow up the neurogenic bladder, is not enough sensitive to detect abnormal renal function and should continue to be associated with an evaluation of renal function, which is suitable for neurological patients. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- E Braley-Berthoumieux
- Service de médecine physique et de réadaptation, centre hospitalier universitaire Rangueil, 1, avenue Jean-Poulhès, 31059 Toulouse 1, France
| | - X Gamé
- Département d'urologie et de transplantation rénale et d'andrologie, centre hospitalier universitaire Rangueil, 1, avenue Jean-Poulhès, 31059 Toulouse 2, France
| | - P Marque
- Service de médecine physique et de réadaptation, centre hospitalier universitaire Rangueil, 1, avenue Jean-Poulhès, 31059 Toulouse 1, France
| | - X de Boissezon
- Service de médecine physique et de réadaptation, centre hospitalier universitaire Rangueil, 1, avenue Jean-Poulhès, 31059 Toulouse 1, France
| | - P Rischmann
- Département d'urologie et de transplantation rénale et d'andrologie, centre hospitalier universitaire Rangueil, 1, avenue Jean-Poulhès, 31059 Toulouse 2, France
| | - E Castel-Lacanal
- Service de médecine physique et de réadaptation, centre hospitalier universitaire Rangueil, 1, avenue Jean-Poulhès, 31059 Toulouse 1, France.
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Mingat N, Villar E, Allard J, Castel-Lacanal E, Guillotreau J, Malavaud B, Rischmann P, Tack I, Ruffion A, Gamé X. Prospective Study of Methods of Renal Function Evaluation in Patients With Neurogenic Bladder Dysfunction. Urology 2013; 82:1032-7. [DOI: 10.1016/j.urology.2013.07.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Revised: 07/13/2013] [Accepted: 07/16/2013] [Indexed: 02/02/2023]
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Hikita K, Honda M, Kawamoto B, Panagiota T, Inoue S, Hinata N, Muraoka K, Takenaka A. Botulinum toxin type A injection for neurogenic detrusor overactivity: Clinical outcome in Japanese patients. Int J Urol 2012; 20:94-9. [DOI: 10.1111/j.1442-2042.2012.03218.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2012] [Accepted: 09/30/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Katsuya Hikita
- Division of Urology; Department of Surgery; Tottori University Faculty of Medicine; Yonago; Tottori; Japan
| | - Masashi Honda
- Division of Urology; Department of Surgery; Tottori University Faculty of Medicine; Yonago; Tottori; Japan
| | - Bunya Kawamoto
- Division of Urology; Department of Surgery; Tottori University Faculty of Medicine; Yonago; Tottori; Japan
| | - Tsounapi Panagiota
- Division of Urology; Department of Surgery; Tottori University Faculty of Medicine; Yonago; Tottori; Japan
| | - Seiya Inoue
- Division of Urology; Department of Surgery; Tottori University Faculty of Medicine; Yonago; Tottori; Japan
| | - Nobuyuki Hinata
- Division of Urology; Department of Surgery; Tottori University Faculty of Medicine; Yonago; Tottori; Japan
| | - Kuniyasu Muraoka
- Division of Urology; Department of Surgery; Tottori University Faculty of Medicine; Yonago; Tottori; Japan
| | - Atsushi Takenaka
- Division of Urology; Department of Surgery; Tottori University Faculty of Medicine; Yonago; Tottori; Japan
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Durham-Lee JC, Mokkapati VUL, Johnson KM, Nesic O. Amiloride improves locomotor recovery after spinal cord injury. J Neurotrauma 2011; 28:1319-26. [PMID: 21534729 PMCID: PMC3136742 DOI: 10.1089/neu.2011.1921] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Amiloride is a drug approved by the United States Food and Drug Administration, which has shown neuroprotective effects in different neuropathological conditions, including brain injury or brain ischemia, but has not been tested in spinal cord injury (SCI). We tested amiloride's therapeutic potential in a clinically relevant rat model of contusion SCI inflicted at the thoracic segment T10. Rats receiving daily administration of amiloride from 24 h to 35 days after SCI exhibited a significant improvement in hindlimb locomotor ability at 21, 28, and 35 days after injury, when compared to vehicle-treated SCI rats. Rats receiving amiloride treatment also exhibited a significant increase in myelin oligodendrocyte glycoprotein (MOG) levels 35 days after SCI at the site of injury (T10) when compared to vehicle-treated controls, which indicated a partial reverse in the decrease of MOG observed with injury. Our data indicate that higher levels of MOG correlate with improved locomotor recovery after SCI, and that this may explain the beneficial effects of amiloride after SCI. Given that amiloride treatment after SCI caused a significant preservation of myelin levels, and improved locomotor recovery, it should be considered as a possible therapeutic intervention after SCI.
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Affiliation(s)
- Julieann C. Durham-Lee
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, Texas
| | - Venkata Usha L. Mokkapati
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, Texas
| | - Kathia M. Johnson
- Department of Neuroscience and Cell Biology, University of Texas Medical Branch, Galveston, Texas
| | - Olivera Nesic
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, Texas
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Kuo HC, Liu SH. Effect of repeated detrusor onabotulinumtoxinA injections on bladder and renal function in patients with chronic spinal cord injuries. Neurourol Urodyn 2011; 30:1541-5. [PMID: 21717505 DOI: 10.1002/nau.21146] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Accepted: 04/01/2011] [Indexed: 11/10/2022]
Abstract
AIMS To investigate the therapeutic effects of repeated detrusor onabotulinumtoxinA injections on urinary incontinence and renal function in patients with chronic spinal cord injuries (SCI). METHODS Patients with suprasacral SCI were enrolled. OnabotulinumtoxinA 200 U detrusor injections were repeated every 6 months for four times. Patients were instructed to perform clean intermittent catheterization during the treatment and follow-up periods. Videourodynamic study and 99mTc-DTPA renal scanning for glomerular filtration rate (GFR) were performed at screening and every 3 months to assess the therapeutic effects on bladder and renal function. Quality of life was measured by the UDI-6, IIQ-7, and self-assessed QoL indices. Adverse events were also recorded. RESULTS A total of 33 patients completed the study, 30 had improvement in incontinence grade (n = 18) or became completely dry (n = 12) after initial and subsequent onabotulinumtoxinA injections. Mean bladder capacity increased from 207 ± 111 to 412 ± 33 ml and mean detrusor pressure decreased from 39.8 ± 21.7 to 20.6 ± 19.1 cmH(2) O (all P < 0.05). However, the mean GFR decreased from 93.4 ± 20.4 to 83.5 ± 24 ml/min (P = 0.028). A significant reduction in GFR was noted in patients with bladder compliance that increased by <10 cmH(2) O (P = 0.002) and in patients with Pdet decreased by <10 cmH(2) O after treatment (P = 0.036). All 30 patients with improvement in incontinence grade satisfied with treatment result. CONCLUSION This pilot study revealed that repeated detrusor injections of 200 U onabotulinumtoxinA could reduce incontinence grade, increase bladder capacity, and decrease intravesical pressure but this study did not demonstrate an improvement in GFR over a 24-month period in patients with chronic SCI.
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Affiliation(s)
- Hann-Chorng Kuo
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan.
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[Bladder reinnervation with creation of a "somato-autonomic" reflex pathway in spinal cord injured or spina bifida, a new way for treatment?]. Prog Urol 2011; 21:501-7. [PMID: 21872150 DOI: 10.1016/j.purol.2011.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2010] [Revised: 03/25/2011] [Accepted: 04/02/2011] [Indexed: 11/21/2022]
Abstract
CONTEXT The restoration of physiological micturition is a major objective for patients presenting a medullary injury, which is not possible with current treatment. Several recent studies have purposed some techniques for bladder reinnervation. Their purpose was to begin a voluntary micturition by the stimulation of an artificial reflex arc created by the anastomosis of a somatic root with a root innervating the bladder. MATERIALS AND METHODS We searched on Medline and Cochrane for articles in English. The keywords used were: bladder reinnervation, spinal cord injury neurogenic bladder, reflex pathway for micturition. RESULTS These studies reported a variable efficacy as high as 85% of the treated patients. These patients could begin micturition voluntarily, associated with a significant improvement observed in their postoperative urodynamic evaluation. In fact, an improvement of the detrusor external sphincter dyssynergia and/or bladder overactivity was reported, and the patients presented a better quality of life by the control of their micturition associated with an improvement in continence with no need for intermittent catheterisation. However, these results were variable from one study to the other, and certain results seem difficult to explain notably concerning the abolition of bladder overactivity and the improvement of the detrusor external sphincter dyssynergia. CONCLUSION Further experimental studies are still required, notably with animals to confirm the encouraging results of these initial studies, and to better understand the mechanism before possible routine patient use.
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Ruffion A. [Do trans-rectal urinary derivation techniques still have a place in our armamentarium in 2010?]. Prog Urol 2010; 20:1221-2. [PMID: 21130403 DOI: 10.1016/j.purol.2010.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2010] [Accepted: 04/12/2010] [Indexed: 11/28/2022]
Affiliation(s)
- A Ruffion
- Service d'urologie Lyon-Sud, hospices civils de Lyon, centre hospitalier Lyon-Sud, université Claude-Bernard Lyon-I, bâtiment 3C, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France.
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Mingat N, Kamar N, Guillotreau J, Ribes D, Sallusto F, Cointault O, Malavaud B, Rostaing L, Rischmann P, Durand D, Gamé X. Épidémiologie des patients neurologiques dans une population de transplantés rénaux. Prog Urol 2010; 20:503-7. [DOI: 10.1016/j.purol.2010.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2009] [Revised: 01/12/2010] [Accepted: 01/18/2010] [Indexed: 11/28/2022]
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Damphousse M, Hubeaux K, Weil M, Raibaut P, Lebreton F, Amarenco G. Signes de lutte dans les vessies neurologiques des lésions de la queue de cheval et du cône terminal. Prog Urol 2010; 20:450-7. [DOI: 10.1016/j.purol.2010.01.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2009] [Revised: 12/03/2009] [Accepted: 01/09/2010] [Indexed: 11/29/2022]
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