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Manunta A, Peyronnet B, Olivari-Philiponnet C, Chartier-Kastler E, Saussine C, Phé V, Robain G, Denys P, Even A, Samson E, Grise P, Karsenty G, Hascoet J, Castel-Lacanal E, Charvier K, Guinet-Lacoste A, Chesnel C, Amarenco G, Haffner F, Haddad M, Le Normand L, Perrouin-Verbe MA, Perrouin-Verbe B, De Seze M, Ruffion A, Gamé X. [Guidelines on the urological management of the adult patient with spinal dysraphism (spina bifida)]. Prog Urol 2023; 33:178-197. [PMID: 36609138 DOI: 10.1016/j.purol.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 12/10/2022] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Improved life expectancy and prenatal screening have changed the demographics of spina bifida (spinal dysraphism) which has presently become a disease of adulthood. Urinary disorders affect almost all patients with spinal dysraphism and are still the leading cause of mortality in these patients. The aim of this work was to establish recommendations for urological management that take into account the specificities of the spina bifida population. MATERIALS AND METHODS National Diagnosis and Management Guidelines (PNDS) were drafted within the framework of the French Rare Diseases Plan at the initiative of the Centre de Référence Maladies Rares Spina Bifida - Dysraphismes of Rennes University Hospital. It is a collaborative work involving experts from different specialties, mainly urologists and rehabilitation physicians. We conducted a systematic search of the literature in French and English in the various fields covered by these recommendations in the MEDLINE database. In accordance with the methodology recommended by the authorities (Guide_methodologique_pnds.pdf, 2006), proposed recommendations were drafted on the basis of this literature review and then submitted to a review group until a consensus was reached. RESULTS Bladder dysfunctions induced by spinal dysraphism are multiple and varied and evolve over time. Management must be individually adapted and take into account all the patient's problems, and is therefore necessarily multi-disciplinary. Self-catheterisation is the appropriate micturition method for more than half of the patients and must sometimes be combined with treatments aimed at suppressing any neurogenic detrusor overactivity (NDO) or compliance alteration (anticholinergics, intra-detrusor botulinum toxin). Resort to surgery is sometimes necessary either after failure of non-invasive treatments (e.g. bladder augmentation in case of NDO resistant to pharmacological treatment), or as a first line treatment in the absence of other non-invasive alternatives (e.g. aponeurotic suburethral tape or artificial urinary sphincter for sphincter insufficiency; urinary diversion by ileal conduit if self-catheterisation is impossible). CONCLUSION Spinal dysraphism is a complex pathology with multiple neurological, orthopedic, gastrointestinal and urological involvement. The management of bladder and bowel dysfunctions must continue throughout the life of these patients and must be integrated into a multidisciplinary context.
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Affiliation(s)
- A Manunta
- Centre de référence Spina Bifida-Dysraphismes, CHU Pontchaillou, Rennes, France
| | - B Peyronnet
- Centre de référence Spina Bifida-Dysraphismes, CHU Pontchaillou, Rennes, France.
| | | | - E Chartier-Kastler
- Service d'Urologie, GH Pitié-Salpétrière, APHP, Paris, France; Sorbonne Université, Paris, France; Service de médecine physique et réadaptation, Hôpital Raymond-Poincaré, APHP, Garches, France
| | - C Saussine
- Service d'urologie, les hôpitaux universitaires de Strasbourg, Strasbourg, France
| | - V Phé
- Service d'urologie, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France
| | - G Robain
- Service de médecine physique et réadaptation, Hôpital Rotschild, APHP, Paris, France
| | - P Denys
- Service de médecine physique et réadaptation, Hôpital Raymond-Poincaré, APHP, Garches, France; Faculté de médecine Paris Ouest, Université de Versailles-Saint-Quentin-en-Yvelines, Garches, France
| | - A Even
- Service de médecine physique et réadaptation, Hôpital Raymond-Poincaré, APHP, Garches, France; Faculté de médecine Paris Ouest, Université de Versailles-Saint-Quentin-en-Yvelines, Garches, France
| | - E Samson
- Centre de référence Spina Bifida-Dysraphismes, CHU Pontchaillou, Rennes, France
| | - P Grise
- Service d'urologie, CHU Rouen, Rouen, France
| | - G Karsenty
- Aix-Marseille Université, urologie et transplantation rénale, Hôpital La Conception, AP-HM, Marseille, France
| | - J Hascoet
- Centre de référence Spina Bifida-Dysraphismes, CHU Pontchaillou, Rennes, France
| | - E Castel-Lacanal
- CHU Toulouse, service de médecine physique et de réadaptation et ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France
| | - K Charvier
- Service de médecine physique et réadaptation, Hôpital Henry-Gabrielle, Hospices civils de Lyon, Saint-Genis-Laval, France
| | - A Guinet-Lacoste
- Sorbonne Université, GRC 001, GREEN Groupe de recherche clinique en neuro-urologie, AP-HP, Hôpital Tenon, 75020 Paris, France
| | - C Chesnel
- Sorbonne Université, GRC 001, GREEN Groupe de recherche clinique en neuro-urologie, AP-HP, Hôpital Tenon, 75020 Paris, France; Service de neuro-urologie et explorations périnéales, Hôpital Tenon, AP-HP, Paris, France
| | - G Amarenco
- Sorbonne Université, GRC 001, GREEN Groupe de recherche clinique en neuro-urologie, AP-HP, Hôpital Tenon, 75020 Paris, France; Service de neuro-urologie et explorations périnéales, Hôpital Tenon, AP-HP, Paris, France
| | - F Haffner
- ASBH, Association nationale Spina Bifida et Handicaps associés, 94420 Le Plessis Trevise, France
| | - M Haddad
- Service de chirurgie viscérale et urologie pédiatrique, AP-HM, Marseille, France
| | - L Le Normand
- Service d'urologie, CHU de Nantes, Nantes, France
| | | | - B Perrouin-Verbe
- Service de médecine physique et réadaptation, CHU de Nantes, Nantes, France
| | - M De Seze
- Spécialiste en médecine physique et de réadaptation, Clinique St.-Augustin, Bordeaux, France
| | - A Ruffion
- Service d'urologie, Hospices civils de Lyon, Lyon, France
| | - X Gamé
- Département d'urologie, transplantation rénale et andrologie, CHU Rangueil, Université Paul-Sabatier, Toulouse, France
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Charvier K, Bonniaud V, Waz D, Desprez C, Leroi AM. Correction to: Use of a new transanal irrigation device for bowel disorder management by patients familiar with the irrigation technique: a prospective, interventional, multicenter pilot study. Tech Coloproctol 2020; 25:151. [PMID: 33108552 DOI: 10.1007/s10151-020-02361-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- K Charvier
- Department of Physical Medicine and Rehabilitation, Henry Gabrielle Hospital, Lyon University Hospital Center, 69230, St Genis Laval, France.
| | - V Bonniaud
- Department of Physical Médicine and Rehabilitation, Le Bocage Hospital, Dijon Regional University Hospital Center, Dijon, France
| | - D Waz
- Department of Physical Medicine and Rehabilitation, Henry Gabrielle Hospital, Lyon University Hospital Center, 69230, St Genis Laval, France
| | - C Desprez
- Department of Digestive Physiology and CIC-CRB 1404, Normandie Univ, UNIROUEN, INSERM U1073, Rouen University Hospital, Rouen, France
| | - A-M Leroi
- Department of Digestive Physiology and CIC-CRB 1404, Normandie Univ, UNIROUEN, INSERM U1073, Rouen University Hospital, Rouen, France
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Godmer M, Guinet-Lacoste A, Charvier K, Luauté J, Rode G, Soler JM, Hadiji N. [Is there any obstruction other than prostatic obstruction in Idiopathic Parkinson's Disease?]. Prog Urol 2019; 29:579-585. [PMID: 31302008 DOI: 10.1016/j.purol.2019.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 06/10/2019] [Accepted: 06/12/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To highlight the existence of pseudo-dyssynergia in Idiopathic Parkinson's Disease (IPD) constituting a functional bladder outlet obstruction. MATERIALS AND METHODS A retrospective study was conducted by including men with a confirmed diagnose of IPD who participated in the SIROCCO rehabilitation program. Patients included clinically exhibited overactive bladder and voiding dysfunction without prostatic hypertrophy ultrasounded. They have been clinically assessed by the Urinary Symptoms Profile (USP) urinary symptom score. Bladder outlet obstruction was assessed by the pressure-flow study. Urodynamic obstruction has been quantified by the bladder obstruction index which depends on detrusor pressure at maximum flow rate and maximum flow rate. It has been defined by a BOOI>40. RESULTS The pressure-flow profile was analyzed in 5 patients who met the inclusion criteria. In this group of 5 patients with IPD, the diagnosis was made on average 10.6 years (7-14) before the pressure-flow studies were performed. Our results objectified 4 patients obstructive among 5 and one equivocal patient. A striated pseudo-dyssynergia was found in the 3 obstructive patients and associated with a smooth pseudodyssynergia in one patient. CONCLUSION We have observed, in this short series, a pseudo-dyssynergia by subjects suffering from IPD. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- M Godmer
- Service de médecine physique et de réadaptation, rééducation neurologique, hôpital Henry-Gabrielle, CHU de Lyon, 69230 Saint-Genis-Laval, France; Service de MPR pédiatrique neurologique, Centre Médical Romans Ferrari, rue de la Chanal-Miribel, 01700 Miribel, France.
| | - A Guinet-Lacoste
- Hôpital Henry Gabrielle, Hospices Civils de Lyon, 20, route de Vourles, 69230 Saint-Genis-Laval, France.
| | - K Charvier
- Hôpital Henry Gabrielle, Hospices Civils de Lyon, 20, route de Vourles, 69230 Saint-Genis-Laval, France; Service d'urologie Pr-Alain-Ruffion, centre hospitalier Lyon Sud, Hospices Civils de Lyon, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France.
| | - J Luauté
- Service de médecine physique et de réadaptation, rééducation neurologique, hôpital Henry-Gabrielle, CHU de Lyon, 69230 Saint-Genis-Laval, France; Université de Lyon, université Lyon 1, 69100 Villeurbanne, France; Centre de recherche en neuroscience de Lyon (CRNL), équipe IMPACT, Inserm, U1028, CNRS, UMR5292, 69675 Bron, France.
| | - G Rode
- Service de médecine physique et de réadaptation, rééducation neurologique, hôpital Henry-Gabrielle, CHU de Lyon, 69230 Saint-Genis-Laval, France; Centre de Recherche en Neurosciences de Lyon, ImpAct Team, Institut National de la Santé et de la Recherche Médicale U1028, Centre National de la Recherche Scientifique UMR5292, Université Claude Bernard Lyon 1, Lyon, France.
| | - J M Soler
- Laboratoire de neuro-urologie et de sexologie, Centre Bouffard, Vercelli, 66290 Cerbère, France.
| | - N Hadiji
- Hôpital Henry Gabrielle, Hospices Civils de Lyon, 20, route de Vourles, 69230 Saint-Genis-Laval, France; Service de neuro-urologie, Centre Médical Germaine-Revel, 69440 Saint-Maurice-sur-Dargoire, France.
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Tamarelle B, Charvier K, Badet L, Terrier JE, Grise P, Mellier G, Golfier F, Ruffion A. [Notice of expert for modality and prescriptions limits of local estrogenotherapy for urinairy inconfinence in women]. Prog Urol 2017; 27:585-593. [PMID: 28844320 DOI: 10.1016/j.purol.2017.07.238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 07/19/2017] [Accepted: 07/19/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To develop a consensus of experts on the use of local estrogens in female urinary incontinence. MATERIAL AND METHOD Following a formalized consensus method (DELPHI), a questionnaire was produced and sent to a first round and then to a second round of experts. The questionnaire consisted of proposals for recommendations for the use of local estrogens in the context of female urinary incontinence. The Survey Monkey® survey software allowed the questionnaire to be distributed and the answers obtained to be analyzed. RESULTS Eight experts responded to the first round questionnaire. Seven formulations were deleted, 3 amended and 4 added to the first round questionnaire following expert advice. Twenty-six experts replied to the second round questionnaire, 24 of which were complete. Ten of the 21 proposals were approved at more than 80%, including five with strong agreement regarding the recognized benefit of local estrogens in urinary incontinence due to overactive bladder, the absence of data from the literature to demonstrate over-risk of hormone-dependent cancer under local estrogens and the need for follow-up of patients under this treatment. Six proposals were not the subject of a consensus and concerned the prescription modalities (maximum duration, effective minimum dose, prescription before surgery for incontinence). CONCLUSION Although local estrogens did not have regulatory approval in urinary incontinence, more than 80% of these experts recognized their benefit in the management of urinary incontinence in women with vulvo-vaginal atrophy, particularly in the case of urinary urge incontinence. LEVEL OF PROOF 4.
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Affiliation(s)
- B Tamarelle
- Centre hospitaliser Lyon-Sud, 165, chemin du grand Revoyer, 69310 Pierre-Bénite, France.
| | - K Charvier
- Centre Henry-Gabrielle, 20, route de Vourles, 69230 Saint-Genis-Laval, France.
| | - L Badet
- Centre Edouard-Herriot, 5, place d'asonval, 69003 Lyon, France.
| | - J-E Terrier
- Centre hospitaliser Lyon-Sud, 165, chemin du grand Revoyer, 69310 Pierre-Bénite, France.
| | - P Grise
- Centre hospitalier de Rouen-Charles-Nicole, 1, rue de Germont, 76000 Rouen, France.
| | - G Mellier
- Hopital Femme-Mère-et-Enfant, 59, boulevard pinel, 69677 Bron, France.
| | - F Golfier
- Centre hospitaliser Lyon-Sud, 165, chemin du grand Revoyer, 69310 Pierre-Bénite, France.
| | - A Ruffion
- Centre hospitaliser Lyon-Sud, 165, chemin du grand Revoyer, 69310 Pierre-Bénite, France.
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Peyronnet B, Sanson S, Amarenco G, Castel-Lacanal E, Chartier-Kastler E, Charvier K, Damphousse M, Denys P, de Seze M, Egon G, Even A, Forin V, Karsenty G, Kerdraon J, le Normand L, Loche CM, Manunta A, Mouracade P, Phe V, Previnaire JG, Ruffion A, Saussine C, Schurch B, Game X. Définition et prise en charge de l’échec d’une première injection de toxine botulique Botox® 200 U pour hyperactivité détrusorienne neurogène : résultats de l’enquête DETOX. Prog Urol 2015; 25:1219-24. [DOI: 10.1016/j.purol.2015.07.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 07/30/2015] [Accepted: 07/31/2015] [Indexed: 11/16/2022]
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Tamarelle B, Charvier K, Del Aguila C, Courtois F, Rode G, Ruffion A. [Ejaculation capacity in spinal cord injured patients carrying an endo-urethral stent for incontinentation: Descriptive study]. Prog Urol 2015; 25:482-8. [PMID: 25724862 DOI: 10.1016/j.purol.2015.01.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 01/26/2015] [Accepted: 01/27/2015] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To assess the impact of endo-urethral stent (EUP) of incontinentation in spinal cord injured (SCI) men on ejaculation capacity. FIRST CRITERIA Presence of ejaculation after EUP. SECONDARY CRITERIA Modification on ejaculation type, stimulation mode, possibility of sperm conservation in the same population. POPULATION AND METHODS A descriptive monocentric study including SCI subjects which underwent placement or change of temporary (Mémokath™ or Allium™) or definitive (Mémotherm™) EUP between January 2004 and January 2014 with at least one ejaculatory test. Are identified for each patient: the presence of ejaculation, type of ejaculation, stimulation mode used, number of frozen specimen and results from semen analysis. RESULTS Over 11 men with tetraplegia, complete for motricity, there were 8 (72%) for whom ejaculation was possible after laying EUP. Of these, 6 (55%) had an antegrade or antero-retrograde ejaculation. It was not possible to make a freezing straw in four of them due to infection of semen (2) or terato-oligo-astenospermia (1) or absence of reproductive project (1). CONCLUSION In this small sample, it was found that over 70% ejaculation have been preserved after laying EUP and more than 50% with antegrade or antero-retrograde ejaculation. A larger study would identify how EUP may alter the ejaculatory capacity or quality of the ejaculate. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- B Tamarelle
- Centre hospitalier Lyon Sud, Pierre Bénite, 39, rue de l'Université, 69007 Lyon, France.
| | - K Charvier
- Hôpital Henry-Gabrielle, 69230 Saint-Genis-Laval, France
| | - C Del Aguila
- Hôpital Henry-Gabrielle, 69230 Saint-Genis-Laval, France
| | - F Courtois
- Institut de réadaptation Gingras-Lindsay de Montréal, Canada
| | - G Rode
- Hôpital Henry-Gabrielle, 69230 Saint-Genis-Laval, France
| | - A Ruffion
- Centre hospitalier Lyon Sud, Pierre Bénite, 39, rue de l'Université, 69007 Lyon, France
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Galusca N, Charvier K, Courtois F, Rode G, Rudigoz RC, Ruffion A. [Antibioprophylaxy and urological management of women with spinal cord injury during pregnancy]. Prog Urol 2015; 25:489-96. [PMID: 25684392 DOI: 10.1016/j.purol.2015.01.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 01/14/2015] [Accepted: 01/15/2015] [Indexed: 11/18/2022]
Abstract
OBJECTIVE More and more women with spinal cord injury (SCI) can have a pregnancy. Few data have been published on these pregnancies and their urological impact. We report a series of these cases illustrating the urological experience of specialized centers. METHODS This is a retrospective study that identified pregnancies in women with SCI followed-up between 2000 and 2014. Data covering all urological and obstetric events during pregnancies, before and after implementation of weekly oral cyclic antibiotics (WOCA) program, were collected from medical records. RESULTS Fifteen women with SCI who gave birth to 20 children were included. Three of them were quadriplegics and 12 were paraplegics. All of them performed themselves intermittent catheterization: 11 by urethral way and 4 by high way because carrying a continent cystostomy. Mean follow-up period before pregnancy was 14.6 years [3-27 years IC 95%] and the mean follow-up for the study was 8.5 months [6.5-9 IC 95%]. We observed a reduction of symptomatic urinary tract infections after WOCA onset (13/13 before vs. 0/7 after, P=0.001), a reduction of recurrent urinary infections (6/13 vs. 0/7, P=0.03), a reduction of threats to premature births (8/13 vs. 0/7, P=0.001). Multi-resistant bacteria appeared to increase (0/13 vs. 3/7, P=0.01). We also observed a trend to significant reduction of premature births number (4/13 vs. 0/13, P=0.1) and that of low birth weight (3/13 versus 0/7, P=0.1). The overall neonatal survival rate was 100%. CONCLUSION Our study before/after introduction of a weekly oral cycle antibiotic prophylaxis during pregnancy for women with spinal cord injury showed a significant reduction in symptomatic urinary tract infections and a tendency to improve pregnancy outcomes. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- N Galusca
- Service d'urologie, CHU de Saint-Étienne, avenue Albert-Raimond, 42055 Saint-Étienne, France; Service de rééducation neuropérinéale et sexologique, hôpital Henry-Gabrielle, hospices civils de Lyon, 69230 Saint-Genis-Laval, France.
| | - K Charvier
- Service de rééducation neuropérinéale et sexologique, hôpital Henry-Gabrielle, hospices civils de Lyon, 69230 Saint-Genis-Laval, France
| | - F Courtois
- Department of sexology, université du Québec, CP 8888 succursale centre-ville, H3C 3P8 Montreal, Quebec, Canada
| | - G Rode
- Service de médecine physique et réadaptation, hôpital Henry-Gabrielle, 69230 Saint-Genis-Laval, France
| | - R C Rudigoz
- Service de gynécologie-obstétrique, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, Grande-Rue de la Croix-Rousse, 69317 Lyon cedex 4, France
| | - A Ruffion
- Service d'urologie, centre hospitalier Lyon Sud, hospices civils de Lyon, 69495 Pierre-Bénite, France
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Ruffion A, Tamarelle B, Charvier K, Paparel P, Morel-Journel N. Les prothèses endo-urétrales(PEU) temporaires d’incontinentation ont-elle un impact sur la capacité éjaculatoire des patients ? Prog Urol 2014; 24:829. [DOI: 10.1016/j.purol.2014.08.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Courtois F, Cramp J, Charvier K, Ditor D. La peur des incontinences urinaires durant les relations sexuelles chez les femmes vivant avec une lésion médullaire. Ann Phys Rehabil Med 2014. [DOI: 10.1016/j.rehab.2014.03.883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Charvier K, Courtois F, Côté I, Dahan V. Ejaculation potential following conus and epiconus lesions. Ann Phys Rehabil Med 2013. [DOI: 10.1016/j.rehab.2013.07.626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Charvier K, Courtois F, Côté I, Dahan V. Potentiel éjaculatoire chez les lésions du cône et de l’épicône. Ann Phys Rehabil Med 2013. [DOI: 10.1016/j.rehab.2013.07.620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Perrouin-Verbe B, Courtois F, Charvier K, Giuliano F. Sexualité de la patiente neurologique. Prog Urol 2013; 23:594-600. [DOI: 10.1016/j.purol.2013.01.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2013] [Accepted: 01/14/2013] [Indexed: 11/28/2022]
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Bellaiche S, Di Blasio R, Luauté J, Jacquin-Courtois S, Boisson D, Charvier K, Tell L, Rode G. Clinical signs and radiographic evidence of esophageal perforation after tetraplegia. Ann Phys Rehabil Med 2013; 56:41-50. [PMID: 23375486 DOI: 10.1016/j.rehab.2013.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Accepted: 01/11/2013] [Indexed: 11/17/2022]
Abstract
A diagnosis of esophageal perforation at some time after cervical spine surgery is difficult to establish since there exists no clinical picture specific to tetraplegic patients. We carried out a detailed retrospective study of revelatory clinical manifestations and conventional radiographic data in a series of 16 patients hospitalized at Hôpital Henry-Gabrielle (Lyon, France) for rehabilitation purposes between 1983 and 2010 and who presented this complication. The most frequent clinical picture associates cervical pain, fever and dysphagia. Simple front and side X-rays of the cervical spine led in 77% of the cases to a diagnosis of esophageal perforation. The most prevalent radiographic signs of the latter consist in osteosynthesis hardware or instrumentation failure, prevertebral free air next to the cervical esophagus and enlarged prevertebral space. Visualized esophageal X-rays, also known as series, highlight parenchymal opacity next to the posterior wall of the esophagus. A diagnosis of esophageal perforation needs to be carried out in order to facilitate suitable treatment and avoid the compromising of vital functions.
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Affiliation(s)
- S Bellaiche
- Service de médecine physique et réadaptation neurologique, hôpital Henry-Gabrielle, hospices civils de Lyon, 20, route de Vourles, 69230 Saint-Genis-Laval, France.
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Courtois F, Rodrigue X, Côté I, Boulet M, Vézina JG, Charvier K, Dahan V. Sexual function and autonomic dysreflexia in men with spinal cord injuries: how should we treat? Spinal Cord 2012; 50:869-77. [PMID: 22869221 DOI: 10.1038/sc.2012.83] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Systematic review. OBJECTIVES Review the literature on the acute or prophylactic treatment of autonomic dysreflexia in the context of sexual activities. SETTING International. METHODS Medline search using AD and spinal cord injury and all years of publication. RESULTS Thirty-seven papers on the specific treatment of AD showed that nifedipine, prazosin, captopril and clonidine are candidates in the context of sexual activities. Prazosin, however, has an initial hypotensive effect requiring to begin treatment 12 h before intercourse, which makes it less ideal for spontaneous sexual activities. Captopril has an initial hypotensive effect and was only studied in acute AD. Its usefulness in prophylaxis remains to be demonstrated. Clonidine has successfully been used clinically for decades, but never studied in randomized control trials. Nifedipine remains the most widely studied and significant treatment of AD whether in acute or prophylactic conditions. Recent concerns suggest increased cardiovascular risks with sublingual nifedipine in non-SCI populations, but negative long-term effects have not been reported in the SCI population. CONCLUSION Sexual function is a priority for men with SCI. As sexual activities, in particular ejaculation, can be a source of AD, adequate treatments and prophylaxis must be considered in the context of sexual activities. Experts must meet and conclude on the thresholds, parameters and treatments that should be considered in the long-term management of AD in the context of sexual function in men with SCI.
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Affiliation(s)
- F Courtois
- Outpatient Clinic, Institut de Réadaptation en Déficience Physique de Québec, Quebec, Quebec, Canada.
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Fourtassi M, Charvier K, Hajjioui A, Havé L, Rode G. [Transanal irrigation for bowel and anorectal management in spinal cord-injured patients]. Prog Urol 2012; 22:467-74. [PMID: 22732582 DOI: 10.1016/j.purol.2012.04.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Accepted: 03/30/2012] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Bowel dysfunction and disordered defecation are very common after spinal cord injury (SCI) and can have a major impact on patients' social life and quality of life. The aim of this study was to assess the safety and efficacy of transanal irrigations (TAI) in the management of Bowel dysfunction in SCI patients. METHODS Forty-five consecutive SCI patients using TAI were retrospectively included. TAI efficacy was assessed through Neurogenic Bowel Dysfunction (NBD) score recorded before and after 8 weeks of regular use. Possible side effects were assessed with a semi-structured questionnaire. Patients who started TAI use at least 6 months previously were contacted to assess long-term compliance, efficacy and safety of TAI. RESULTS After 8 weeks of regular use of TAI, the average NBD scores decreased by four points (P<0.0001) with a specific improvement in the items related to stool frequency (P: 0.036), occurrence of malaise, headache, or sweating during defecation (P: 0.043), use of drugs against constipation (P: 0.007) and frequency of fecal incontinence (P: 0.001). The main side effects were bleeding (10%) and abdominal pain (8%). At 6 months, 80% of the assessed patients had continued regular use of TAI with no particular problem. CONCLUSION This study showed good medium and long-term efficacy and safety of TAI in the management of bowel dysfunction and defecation disorders in spinal cord-injured patients.
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Affiliation(s)
- M Fourtassi
- Service de neuropérinéologie et sexologie, hôpital Henry-Gabrielle, hospices civil de Lyon, 20, route de Vourles, 69230 Saint-Genis-Laval, France.
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Guinet A, Bisseriex H, Perrouin-Verbe B, Le Breton F, Charvier K, Amarenco G. SEA-MS-F (Sexual Expectation Assessment in Multiple Sclerosis) : mise au point et validation d’une échelle d’évaluation des attentes sexuelles des patientes atteintes de sclérose en plaques (SEP). Ann Phys Rehabil Med 2011. [DOI: 10.1016/j.rehab.2011.07.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Courtois F, Charvier K, Vézina J, Côté I, Boulet M, Jacquemin G. Évaluation de la fonction sexuelle et capacité orgasmique de la femme blessée médullaire. Ann Phys Rehabil Med 2011. [DOI: 10.1016/j.rehab.2011.07.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Courtois F, Charvier K, Vézina J, Côté I, Boulet M, Jacquemin G. Assessment of sexual function and orgasmic capacity of women with spinal cord injury. Ann Phys Rehabil Med 2011. [DOI: 10.1016/j.rehab.2011.07.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Chartier-Kastler E, Lauge I, Ruffion A, Goossens D, Charvier K, Biering-Sørensen F. Safety of a new compact catheter for men with neurogenic bladder dysfunction: a randomised, crossover and open-labelled study. Spinal Cord 2011; 49:844-50. [DOI: 10.1038/sc.2011.5] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Courtois F, Charvier K, Leriche A, Vézina JG, Jacquemin G. Réactions sexuelles et orgasme chez le patient traumatisé médullaire : un modèle de rééducation/réadaptation. Sexologies 2009. [DOI: 10.1016/j.sexol.2009.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Courtois F, Charvier K, Leriche A, Vézina JG, Jacquemin G. Sexual and climactic responses in men with traumatic spinal injury: A model for rehabilitation. Sexologies 2009. [DOI: 10.1016/j.sexol.2009.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Courtois F, Charvier K, Leriche A, Côté M, Lemieux A. L’évaluation et le traitement des troubles des réactions sexuelles chez l’homme et la femme blessés médullaires. Sexologies 2009. [DOI: 10.1016/j.sexol.2007.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Lefaucheur J, Labat J, Amarenco G, Herbaut A, Prat-Pradal D, Benaim J, Aranda B, Arne-Bes M, Bonniaud V, Boohs P, Charvier K, Daemgen F, Dumas P, Galaup J, Ismael SS, Kerdraon J, Lacroix P, Lagauche D, Lapeyre E, Lefort M, Leroi A, Opsomer R, Parratte B, Prévinaire J, Raibaut P, Salle J, Scheiber-Nogueira M, Soler J, Testut M, Thomas C. WITHDRAWN: What is the place of electroneuromyographic studies in the diagnosis and management of pudendal neuralgia related to entrapment syndrome? Neurophysiol Clin 2007. [DOI: 10.1016/j.neucli.2007.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Labat JJ, Riant T, Robert R, Amarenco G, Lefaucheur JP, Benaïm J, De Tayrac R, Galaup JP, Guérineau M, Khalfallah M, Lassaux A, Le Fort M, Lucot JP, Rabischong B, Rigaud J, Siproudhis L, Arné-Bès MC, Bonniaud V, Charvier K, Dumas P, Herbault AG, Lapeyre E, Leroi AM, Prat Pradal D, Soler JM, Testut MF, Raibaut P, Scheiber-Nogueira MC, Thomas C. Critères diagnostiques d’une névralgie pudendale (Critères de Nantes). ACTA ACUST UNITED AC 2007. [DOI: 10.1007/s11608-007-0114-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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