Clinical efficacy of intravesical electrostimulation on incomplete spinal cord patients suffering from chronic neurogenic non-obstructive retention: a 15-year single centre retrospective study

Lombardi, G; Celso, Maria; Mencarini, Marco; Nelli, Federico; Popolo, Giulio Del

doi:10.1038/sc.2012.120

Cited by 17 publications

(18 citation statements)

References 17 publications

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“…In cases of persistent detrusor acontractility, sacral neuromodulation (for nonobstructive causes), intravesical electrostimulation, latissimus dorsi detrusor myoplasty, or continent catheterizable channels have been utilized in differing clinical scenarios [27,28]. …”

Section: Treatments For Detrusor Acontractilitymentioning

confidence: 99%

Bladder Emptying: Contractility

Bacsu

Hou

Lemack

2014

Rapid and Practical Interpretation of Urodynamics

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Bladder contractility is a term used to describe the strength of bladder detrusor muscle contractions [1,2]. Since bladder contraction requires parasympathetic stimulation, the detrusor pressure depends on the inherent strength of the detrusor muscle itself, which can be affected by a variety of factors, and intact neural circuitry. Loss of either would clearly impact contractile strength and overall bladder function. Normal detrusor function is initiated by a drop in urethral pressure followed by a continuous detrusor contraction which leads to complete bladder emptying within a normal time span. For many women who void primarily by urethral relaxation, this contraction may be modest or even absent. Detrusor underactivity implies a detrusor contraction of reduced strength and/or duration resulting in prolonged voiding, and/or a failure to achieve complete bladder emptying. An acontractile detrusor identifies the condition where no detrusor contraction is noted, also typically associated with prolonged voids, incomplete emptying, or inability to void altogether. Examples of each of these conditions are demonstrated in urodynamic tracings shown in the remainder of the chapter.Other factors, such as outlet resistance, can also greatly affect bladder contractility. Enhanced outlet resistance, in the setting of bladder outlet obstruction, will result in increased detrusor force for a variable period of time, followed potentially by a loss of force depending on the severity and duration of obstruction. Similarly diminished outlet resistance, for example in the setting of stress urinary incontinence, has been shown to result in lowered detrusor pressures during voiding.

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Section: Treatments For Detrusor Acontractilitymentioning

confidence: 99%

Bladder Emptying: Contractility

Bacsu

Hou

Lemack

2014

Rapid and Practical Interpretation of Urodynamics

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“…Retrospektivna studija, koja ispituje kliničku efikasnost intravezikalne stimulacije na neurogenu neopstruktivnu retenciju nastalu nakon inkompletnog oštećenja kičmene mož-dine, ukazuje da kraće vrijeme proteklo od oštećenja do terapije povećava vjerovatnoću za pozitivan rezultat [12]. Neki autori smatraju da rezultati, koji su prikazani na tretmanu započetom šest mjeseci nakon oštećenja, nisu posljedica elektrostimulacije već vremena proteklog od oštećenja do terapije i da je to bio dovoljan period za spontano poboljšanje neurološkog statusa [23].…”

Section: Diskusijaunclassified

“…Nalazi urodinamskog ispitivanja kod pacijenata prije i nakon terapije ukazuju na poboljšanje senzacije bešike nakon elektrostimulacije [12]. Autori smatraju da su tri nedjelje terapije bile dovoljne da pokažu pozitivan efekat ili njegov izostanak na oporavak bešike.…”

Section: Diskusijaunclassified

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Faktori koji utiču na ishod liječenja sindroma kaude ekvine

Bućma¹,

Bajić²,

Nalesnik³

et al. 2016

Biomedicinska istraž.

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Kratak sadržajUvod. Grupa znakova i simptoma koji se javljaju kao rezultat oštećenja nervnih korjenova caudae equinae smještenih u kičmenom kanalu nosi naziv sindrom kaude ekvine (cauda equina syndrome). Najčešće je uzrokovana lumbalnom hernijacijom intervertebralnog diska. Klinička slika se karakteriše bolom u krsnom, glutealnom i perinealnom regionu, bolom duž zadnje strane donjeg ekstremiteta, utrnulošću i motornim i senzornim deficitima na donjim ekstremitetima. Može se javiti i disfunkcija mokraćne bešike i potencije.Prikaz bolesnika. Pacijent dolazi na pregled kod fizijatra zbog jakog bola u slabinskom segmentu, koji se propagirao duž oba donja ekstremiteta praćen osjećajem slabosti, više lijevo, te nemogućnosti pražnjenja mokraćne bešike. Snimak dobijen nuklearnom magnetnom rezonancom (NMR) pokazuje protruziju intravertebralnog diska na dva nivoa. Pacijent je podvrgnut operativnom zahvatu: Hemilaminectomia L4 l. sin et foraminotomia L5-S1 l. sin, extirpatio disci. Mjesec dana nakon operativnog zahvata provodi postoperativnu stacionarnu rehabilitaciju. Na prijemu je detektovana slabost plantarnih fleksora lijevog stopala, te trnjenje u istom, nepotpuno pražnjenje bešike, nemogućnost kontrole spoljašnjeg analnog sfinktera i disfunkcija potencije. Nalaz urofloumetrije potvrdio je tešku hipotoniju detrusora mokraćne bešike koja graniči sa atonijom. Pacijent je proveo fizikalni tretman, te dva ciklusa elektrostimulacije detrusora mokraćne bešike. Kontrolni urodinamski nalaz bez značajnijih promjena u odnosu na prethodni. Nakon provedenog liječenja pacijent ima osjećaj olakšanog mokrenja, seksualna disfunkcija je manjа, snaga plantarnih fleksora je poboljšana.Zaključak. Na samom početku liječenja bili su prisutni faktori koji su ukazivali na teškoće u ishodu liječenja (hronični bol, odloženo operativno liječenje, odložena rehabilitacija). Smatramo da je poboljšanje nastupilo kao posljedica psihološkog stanja pacijenta koji uspijeva uticati na aktivnosti sfinktera.

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“…IVES proved to have a role in detrusor reinforcement in ApBO; up to two-thirds of patients with a weak detrusor regained balanced voiding [45] . Of patients with incomplete spinal cord injury and who had chronic neurogenic non-obstructive urinary retention, 37.2% responded to IVES and 83.3% experienced again the sensation of bladder filling [46] .…”

Section: The Treatment Of Female Vdmentioning

confidence: 99%

Voiding dysfunction in women: How to manage it correctly

Raheem

Madersbacher

2013

Arab Journal of Urology

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IntroductionOf women aged >40 years, 6% have voiding dysfunction (VD), but the definition for VD in women with respect to detrusor underactivity (DU) and bladder outlet obstruction (BOO) is not yet clear. In this review we address the current literature to define the diagnosis and treatment of VD more accurately.MethodsWe used the PubMed database (1975–2012) and searched for original English-language studies using the keywords ‘female voiding dysfunction’, ‘detrusor underactivity’, ‘acontractile detrusor’ and ‘bladder outlet obstruction and urinary retention in women’. We sought studies including the prevalence, aetiology, pathogenesis, diagnosis and treatment of female VD.ResultsIn all, 20 original studies were identified using the selected search criteria, and another 45 were extracted from the reference lists of the original papers. All studies were selected according to their relevance to the current topic and the most pertinent reports were incorporated into this review.ConclusionFemale VD might be related to DU or/and BOO. Voiding and storage symptoms can coexist, making the diagnosis challenging, with the need for a targeted clinical investigation, and further evaluation by imaging and urodynamics. To date there is no universally accepted precise diagnostic criterion to diagnose and quantify DU and BOO in women. For therapy, a complete cure might not be possible for patients with VD, therefore relieving the symptoms and minimising the long-term complications associated with it should be the goal. Treatment options are numerous and must be applied primarily according to the underlying pathophysiology, but also considering disease-specific considerations and the abilities and needs of the individual patient. The treatment options range from behavioural therapy, intermittent (self-)catheterisation, and electrical neuromodulation and neurostimulation, and up to urinary diversion in rare cases.

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Clinical efficacy of intravesical electrostimulation on incomplete spinal cord patients suffering from chronic neurogenic non-obstructive retention: a 15-year single centre retrospective study

Cited by 17 publications

References 17 publications

Bladder Emptying: Contractility

Bladder Emptying: Contractility

Faktori koji utiču na ishod liječenja sindroma kaude ekvine

Voiding dysfunction in women: How to manage it correctly

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