Impact Of α-Blockers In Men With Spinal Cord Injury And Upper Tract Stasis

Linsenmeyer, Todd A.; Horton, John A.; Benevento, Joseph

doi:10.1080/10790268.2002.11753612

Cited by 19 publications

(8 citation statements)

References 16 publications

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“…2,3 Another conservative approach is intravesical electrical stimulation (IVES) used for patients with neurogenic bladder, including those with incomplete SCI, to increase their bladder sensations and improve bladder emptying. [4][5][6][7] The aim of the study was to report the results of 15 years of IVES administered to patients with incomplete SCI and N-NOR.…”

Section: Introductionmentioning

confidence: 99%

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

Lombardi¹,

Celso²,

Mencarini³

et al. 2012

Spinal Cord

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Objective: To evaluate the clinical and urodynamic impact of intravesical electrostimulation (IVES) on incomplete spinal cord injury (SCI) patients suffering from chronic neurogenic non-obstructive urinary retention (N-NOR). Methods: One-hundred and two patients underwent at least 28 consecutive daily IVES sessions because objective evidence of detrusor acontractility instead of hypocontractility was detected. Diary entries written at various stages by each patient were compared (7 days before the IVES cycle, 15-21 days into the cycle and 7 days before its end). Responders were patients with a mean 50% reduction in both the number of daily catheterizations and post-void residual urine. Responders underwent further urodynamics at the end of the IVES cycle; patients experiencing first sensation of bladder filling, and the mean volume of first sensation of bladder filling per ml, Qmax ml s À1 , among others, were evaluated. Nineteen individuals who repeated another IVES round were included in this study.Results: Thirty-eight subjects (37.2%) responded to IVES and of those, 83.3% recovered the first sensation of bladder filling after the IVES round. Nineteen responders repeated IVES within 1 year, owing to loss of efficacy. They obtained similar voiding symptoms improvement and urodynamic results as after the first IVES cycle. A timespan of o2 years from SCI to IVES, and the presence of first sensation of bladder filling at baseline represented significant predictive parameters for IVES success (Po0.05) using w 2 -test. Conclusions: IVES represents a possible therapeutic option for incomplete SCI patients with N-NOR.

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Section: Introductionmentioning

confidence: 99%

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

Lombardi¹,

Celso²,

Mencarini³

et al. 2012

Spinal Cord

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“…The high urethral resistance or detrusor sphincter dyssynergia problem was just explained, and botulinum toxin injection into the two urethral sphincters is a promising approach for preventing these unwanted contractions [26]. In addition, for the proximal smoothmuscle sphincter, the use of oral alpha-blocker medication can be used for inhibition [27]. The urinary incontinence from an overactive bladder could be managed by oral anticholinergic medication or low doses of botulinum toxin into the bladder wall [1,[28][29].…”

Section: Discussionmentioning

confidence: 99%

Effective methods of pelvic plexus nerve and bladder stimulation in anesthetized animal model

Bresler

Walter²,

Jahoda³

et al. 2008

JRRD

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Abstract-Urinary retention is a serious urological problem associated with spinal cord injuries (SCIs) and other pelvic disorders. Effective methods of pelvic nerve stimulation were investigated for this problem. Following anesthesia in five dogs, the bladder was surgically exposed. Bladder and anal sphincter pressures were recorded. Testing was first conducted with probe electrodes. Barb electrodes were then implanted with a needle near the pelvic plexus nerves and the bladder wall. We tested different electrode arrangements and stimulating parameters to induce bladder contractions without skeletal muscle stimulation. The pelvic plexus nerves near the bladder were identified, and the barb electrodes were effectively implanted. Stimulation with bipolar and bilateral electrodes induced pressures over 30 cmH 2 O without skeletal muscle activation. Common stimulation parameters were 40 pps, 400 microseconds pulse duration, and 15 to 25 mA stimulating current applied for 3 s. Effective electrode implantation methods were shown. Also identified were electrode arrangements and stimulating parameters that induced strong bladder contractions without skeletal muscle activation. However, voiding studies were not conducted. Further studies with barb electrodes are warranted, and these methods may have applications for bladder stimulation following SCI.

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“…1,2 Moreover, literature reports that with intravesical electrostimulation patients regained detrusor activity and increased awareness of bladder filling. 3,4 However, other authors show negative findings.…”

Section: Introductionmentioning

confidence: 99%

“…Keywords: neurogenic non-obstructive urinary retention; sacral neuromodulation; aseptic intermittent catheterizations; urodynamics INTRODUCTION Neurogenic non-obstructive urinary retention (N-NOR) due to spinal cord lesion (SCL) may be treated with pelvic floor reeducation, or drugs such as alpha-blockers and parasympathomimetics, though these therapies are commonly unsuccessful. 1,2 Moreover, literature reports that with intravesical electrostimulation patients regained detrusor activity and increased awareness of bladder filling. 3,4 However, other authors show negative findings.…”

mentioning

confidence: 99%

Sacral neuromodulation for neurogenic non-obstructive urinary retention in incomplete spinal cord patients: a ten-year follow-up single-centre experience

Lombardi¹,

Musco²,

Celso³

et al. 2014

Spinal Cord

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Objective: To determine the success rate of percutaneous first stage of sacral neuromodulation (SNM) and the efficacy and safety of permanent SNM for incomplete spinal cord lesion (SCL) patients suffering from chronic neurogenic non-obstructive urinary retention (N-NOR). Method: From January 2003 to December 2012, 85 individuals underwent the percutaneous first stage of SNM. Subsequently, only responders who reached a concomitant reduction by at least 50% of volume per catheterization and in the number of catheterizations per day comparing their 7-day voiding diaries at baseline underwent permanent SNM. Final follow-up was conducted by April 2013. Results: Thirty-six individuals responded to percutaneous first stage of SNM. Post-surgery urodynamics documented all patients experiencing first sensation of bladder filling. A statistically significant increase in Qmax ml per sec and decrease in post-voiding residual urine per ml were documented. (Po0.01). First sensation of bladder filling at baseline represented a statistically significant parameter for the success of the first stage SNM (Po0.05). Eleven out of 34 patients at follow-ups were 'inconstant responders' because they returned to similar baseline voiding symptoms, but responded again with an implant on the controlateral S3 sacral root. Two failed twice and responded once again after an S4 sacral root implant. All but one failure occurred more than 3 years after the previous implant. Other drawbacks were resolved telemetrically. Keywords: neurogenic non-obstructive urinary retention; sacral neuromodulation; aseptic intermittent catheterizations; urodynamics INTRODUCTION Neurogenic non-obstructive urinary retention (N-NOR) due to spinal cord lesion (SCL) may be treated with pelvic floor reeducation, or drugs such as alpha-blockers and parasympathomimetics, though these therapies are commonly unsuccessful. 1,2 Moreover, literature reports that with intravesical electrostimulation patients regained detrusor activity and increased awareness of bladder filling. 3,4 However, other authors show negative findings. 5,6 A recent review on the use of sacral neuromodulation (SNM) for neurogenic lower urinary tract dysfunction reports that no definitive conclusions can be drawn from the available evidence regarding this procedure for neurogenic lower urinary tract dysfunction. 7 The aim of this retrospective study is to address the success rate percentage of first stage SNM in individuals with an incomplete SCL. Moreover, medium-and long-term efficacy associated with the safety of permanent SNM on SCL subjects suffering from N-NOR were evaluated.

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Impact Of α-Blockers In Men With Spinal Cord Injury And Upper Tract Stasis

Cited by 19 publications

References 16 publications

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

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

Effective methods of pelvic plexus nerve and bladder stimulation in anesthetized animal model

Sacral neuromodulation for neurogenic non-obstructive urinary retention in incomplete spinal cord patients: a ten-year follow-up single-centre experience

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