Evaluation, treatment, and surveillance of neurogenic detrusor overactivity in spinal cord injury patients

Alsulihem, Ali; Corcos, Jacques

doi:10.20517/2347-8659.2019.007

Cited by 10 publications

(22 citation statements)

References 53 publications

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“…Review of the initial trauma and severity of the SCI with a validated system like the ASIA score is first performed. It is important to consider factors in a male’s medical history, like severe hypertension or history of acute angle closure glaucoma, that may contraindicate the use of medications in the treatment in NLUTD [ 13 ]. A bladder diary may provide information on number of voids and/or straight catheterizations, voiding times, volume voided, amount of fluid ingested, feelings of urgency, and episodes of incontinence [ 14 ].…”

Section: Workupmentioning

confidence: 99%

Spinal cord injury and neurogenic lower urinary tract dysfunction: what do we know and where are we going?

Dodd¹,

Motwani²,

Small³

et al. 2022

JOMH

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One of the well reported but difficult to manage symptoms of spinal cord injury (SCI) is neurogenic lower urinary tract dysfunction (NLUTD). The type of NLUTD is variable based on location and extent of injury. SCI affects more males and NLUTD is especially debilitating for men with incomplete injury. This review summarizes the anatomical basis of NLUTD in SCI and discusses current diagnostic and management strategies that are being utilized clinically. The last two sections address new innovations and emerging discoveries with the goal of increasing scientific interest in improving treatment options for people with SCI. Areas warranting further investigation are pinpointed to address current gaps in knowledge and/or appropriate technology.

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Section: Workupmentioning

confidence: 99%

Spinal cord injury and neurogenic lower urinary tract dysfunction: what do we know and where are we going?

Dodd¹,

Motwani²,

Small³

et al. 2022

JOMH

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“…Los trastornos neurológicos centrales suelen generar alteraciones funcionales del tracto urinario inferior 6 ; la lesión medular es una de las afecciones más frecuentes y conlleva a DNTUI; esta condición afecta a más de 291.000 personas en Estados Unidos, con una incidencia anual de 17.730 casos; se estima que, aproximadamente, entre 70% y 84% de pacientes con LME sufren de esta afección en el tracto urinario 7 , lo que representa un alto costo en la atención médica debido a las complicaciones.…”

Section: Epidemiologíaunclassified

“…En aquellos pacientes que realizan micción espontánea por maniobra de Valsalva, maniobra de Credé y/o cateterismo externo, se deberá medir el residuo postmiccional, ya que valores elevados aumentan el riesgo de infección y deterioro del tracto urinario superior 7 .…”

Section: Evaluación De La Dntuiunclassified

“…En el examen físico debe realizarse una exploración cuidadosa para identificar posibles defectos del piso pélvico, como los prolapsos genitales en la mujer y el tamaño y consistencia de la próstata en el hombre. También es esencial llevar a cabo un examen neurológico completo que incluya tono anal, sensación perineal y reflejo bulbocavernoso 7,8 , al igual que la evaluación de patrones integrales y funcionales con el fin de valorar la habilidad del paciente para la realización del autocateterismo.…”

Section: Evaluación De La Dntuiunclassified

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Manejo integral de la disfunción neurogénica del tracto urinario inferior en lesión medular: actualización

Gutiérrez

Puentes²,

Ramos

2022

Rev Col Med Fis Rehab

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La disfunción neurogénica del tracto urinario inferior es una consecuencia frecuente en pacientes con lesión de la médula espinal y es secundaria a la hiperactividad del músculo detrusor, que compromete dos funciones principales: el almacenamiento y el vaciamiento de la orina por daño en los centros de control neurológico de la micción. Se asocia con una morbimortalidad significativa, altos costos en la atención médica y disminución en la calidad de vida. Por ello se debe detectar y tratar de manera temprana, al igual que realizar un seguimiento estrecho que reduzca el riesgo de deterioro de las vías urinarias superiores. El presente artículo tiene como finalidad revisar algunos concep- tos básicos en relación con la definición, epidemiología, fisiopatología, presentación clínica, complicaciones y, en especial, el tratamiento de esta condición, siendo este último el objetivo de esta revisión.

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“…In the case of a hyperreflexic detrusor, anticholinergic medications or beta-3-agonists can be administered as first-line therapy to reduce bladder pressure. 13 In 90% of patients with neurogenic bladder, the combination of anticholinergics with CIC is sufficient to prevent incontinence and preserve renal function. 18 Anticholinergics, such as oxybutynin, are antagonists at the M3-receptor, thereby preventing detrusor contraction.…”

Section: Pharmacological Managementmentioning

confidence: 99%

Bowel and Bladder Care in Patients With Spinal Cord Injury

Kuris

Alsoof

Osorio

et al. 2021

J Am Acad Orthop Surg

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Complete and incomplete spinal cord injuries affect between 250,000 and 500,000 people on an annual basis worldwide. In addition to sensory and motor dysfunction, spinal cord injury patients also suffer from associated conditions such as neurogenic bowel and bladder dysfunction. The degree of dysfunction varies on the level, degree, and type of spinal cord injury that occurs. In addition to the acute surgical treatment of these patients, spine surgeons should understand how to manage neurogenic bowel and bladder care on both a short-and longterm basis to minimize the risk for complications and optimize potential for rehabilitation. Spinal cord injury (SCI) is a devastating incident that results from traumatic and nontraumatic events leading to spinal cord damage. 1 Leading causes include vehicular accidents, falls, violence (gun-shot injuries), sport-related, and medical or surgical complications. 2 The National Spinal Cord Injury Statistical Center indicates an incidence of 17,810 new cases each year in the United States, with a mean hospital stay length of 11 days. Worldwide, the incidence ranges from 250,000 to 500,000 persons per year.Since 2005, the average age at injury is 40.7 years. Although the life expectancy of SCI has improved dramatically since the 1950s, it remains below the cohort average. 3 After a SCI, the average life expectancy when compared with the general cohort ranges from 18.1% to 88.4% because of factors including age, sex, and the neurologic grouping of injury-with better prognosis in incomplete spinal cord lesions. 3 Incomplete quadriplegia is the most frequent form of SCI (47.2%), followed by complete paraplegia (20.2%), incomplete paraplegia (19.6%), and complete quadriplegia (12.3%). Under 1% of patients will experience complete neurologic recovery by the time of hospital discharge. 2 Bowel and bladder dysfunction have a devastating impact on the quality of life after SCI. Approximately 30% of patients recovering from a SCI are hospitalized on an annual basis, with genitourinary infections the most common cause of readmission (23.5 to 29.8%) and the fifth most common cause of death. Bowel dysfunction is the most reported report with an incidence between 20 and 60% and the ninth most common reason for rehospitalization. 4 The challenges of bowel and bladder dysfunction affect the daily

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Evaluation, treatment, and surveillance of neurogenic detrusor overactivity in spinal cord injury patients

Cited by 10 publications

References 53 publications

Spinal cord injury and neurogenic lower urinary tract dysfunction: what do we know and where are we going?

Spinal cord injury and neurogenic lower urinary tract dysfunction: what do we know and where are we going?

Manejo integral de la disfunción neurogénica del tracto urinario inferior en lesión medular: actualización

Bowel and Bladder Care in Patients With Spinal Cord Injury

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