Incidence of Autonomic Dysreflexia and Silent Autonomic Dysreflexia in Men With Spinal Cord Injury Undergoing Sperm Retrieval: Implications for Clinical Practice

Ekland, M; Krassioukov, Andrei V.; McBride, Kate E.; Elliott, Stacy

doi:10.1080/10790268.2008.11753978

Cited by 78 publications

(46 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We previously, reported episodes of asymptomatic (silent) AD during vibrostimulation procedure for sperm retrieval in individuals with SCI. 18 Vibrostimulation associated with asymptomatic episodes of AD in 62% of participants (average increase in SBP was 65 ± 44 mm Hg). In this study, we reported an individual with a peak BP of 229/ 139 mm Hg who still did not experience any subjective symptoms of AD.…”

Section: Discussionmentioning

confidence: 93%

Autonomic dysreflexia severity during urodynamics and cystoscopy in individuals with spinal cord injury

Liu

Fougere

et al. 2013

Spinal Cord

View full text Add to dashboard Cite

Study Design: Retrospective chart review. Objective: To compare autonomic dysreflexia (AD) severity during urodynamics and cystoscopy in individuals with spinal cord injury (SCI). Setting: Outpatient urological clinic. Methods: Demographic and clinical data were collected from charts of individuals with SCI who had blood pressure (BP) monitoring during urological procedures. Cardiovascular parameters were collected at baseline and during the various stages of two examinations. Results: A total of 21 SCI individuals (mean age 49.4 years) who underwent both procedures developed episodes of AD. The majority of individuals had cervical SCI (85.7%). The median duration of injury was 183 months (ranging from 3 to 530 months). There was statistically more of an increase (P ¼ 0.039) in systolic BP during cystoscopy (67.1 ± 33.8 mm Hg) in comparison with urodynamics (51.8±21.8 mm Hg). The BP response during episodes of AD was more pronounced in individuals with more than 2 years post SCI than with less than 2 years post SCI during both urodynamics and cystoscopy (P ¼ 0.047 and P ¼ 0.010, respectively). Conclusion: Even though cystoscopy filled the bladder to lesser volumes than did urodynamics (150 ml vs 500 ml), during cystoscopy the individuals developed greater changes in systolic BP, indicating that stimulation of the urethra/prostate/internal sphincter region probably is a more potent stimulus of AD than just the filling of the bladder. The severity of AD also increased with time post SCI during both procedures. Considering the high incidence of silent episodes of AD during the urological procedures, it is recommended that monitoring of cardiovascular parameters during these procedures be routinely performed. One of the most common physician-induced causes of AD in individuals with SCI is the use of procedures that involve urinary bladder and urogenital areas. 3 Previously, numerous studies using different groups of individuals with SCI examined CV responses either during urodynamic 3-6 or cystoscopic examination. 7,8 These two procedures both involve urinary bladder distension. However, cystoscopy includes greater stimulation of the urethra and bladder neck afferents during the procedure through urethral/prostate/ internal sphincter passage and dilation, which could then provide more intense afferent stimulation to the spinal cord and trigger more pronounced episodes of AD. Considering the physiological difference

show abstract

Section: Discussionmentioning

confidence: 93%

Autonomic dysreflexia severity during urodynamics and cystoscopy in individuals with spinal cord injury

Liu

Fougere

et al. 2013

Spinal Cord

View full text Add to dashboard Cite

show abstract

“…It could be useful to identify signs of AD, particularly in the context of silent or asymptomatic AD. 23 …”

Section: Discussionmentioning

confidence: 99%

“…17,21,22 AD is usually associated with at least one sign of autonomic arousal, 17 but may sometimes occur unperceived. 23 Upon severe conditions, hypertension can reach levels as high as 250 mm Hg 18 SBP, making the individual at risk of organ dysfunction, cardiovascular events or even death if left untreated.…”

Section: Autonomic Dysreflexiamentioning

confidence: 99%

Sexual function and autonomic dysreflexia in men with spinal cord injuries: how should we treat?

Courtois

Rodrigue²,

Côté³

et al. 2012

Spinal Cord

View full text Add to dashboard Cite

Study design: Systematic review. Objectives: Review the literature on the acute or prophylactic treatment of autonomic dysreflexia (AD) in the context of sexual activities. Setting: International Methods: Medline search using AD and spinal cord injury (SCI). Selected titles for AD treatment included all levels of evidence (randomized placebo control studies, case reports, literature reviews) 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.

show abstract

“…Los síntomas de la DA son variables y van desde la frecuente sudoración y piloerección por encima del nivel de la lesión, hasta crisis que amenazan la vida (Ekland et al, 2008). También son síntomas frecuentes un dolor de cabeza palpitante, un aumento de la espasticidad, congestión nasal, visión borrosa, bradicardia, hipertensión, vasoconstricción por debajo del nivel de la lesión, arritmias, palidez y sofocos (Klenck y Gebke, 2007).…”

Section: Disreflexia Autonómicaunclassified

Lesión medular y ejercicio físico: revisión desde una perspectiva deportiva

Costa

Ávila

Herranz

2016

Redis

View full text Add to dashboard Cite

Para citar: Brizuela, G. et al. (2016): "Lesión medular y ejercicio físico: revisión desde una perspectiva deportiva". Revista Española de Discapacidad, 4 (2): 163-185. ResumenUna de cada 2000 personas en Europa tiene lesión medular (LM), es normalmente más sedentaria que el resto de la población y encuentra diferentes problemas para practicar ejercicio físico (EF), destacando la escasa formación específica de los profesionales del deporte. Con el objetivo de aportar información sobre la LM y su interacción con la práctica deportiva, se realizó una revisión de literatura científica que analiza sus alteraciones músculoesqueléticas, cardiovasculares, respiratorias, de termorregulación, genitourinarias e intestinales, las úlceras por presión, la disreflexia autonómica y los aspectos nutricionales, generando recomendaciones prácticas. Como conclusión, la práctica habitual de EF reduce la incidencia de enfermedades respiratorias y cardiovasculares, mejorando la condición física, la autonomía personal y la salud de las personas con LM, así como su calidad y esperanza de vida, pero es imprescindible conocer sus características particulares tanto para optimizar su rendimiento deportivo como para evitar graves complicaciones médicas. Palabras claveParaplejia, tetraplejia, actividad física, deporte. AbstractOne in 2,000 people in Europe has spinal cord injury (SCI). These persons are usually more sedentary than the rest of the population and encounters different problems to practice physical exercise (PE), in part because of the limited specific training of sports professionals. In order to provide specific information about SCI and its interaction with the practice of sports, a review of scientific literature was carried out. Different kinds of disorders as musculoskeletal, cardiovascular, respiratory, thermoregulation, genitourinary and intestinal, pressure ulcers, autonomic dysreflexia and nutritional aspects were analyzed in order to make useful recommendations. In conclusion, the practice of PE reduces the incidence of respiratory and cardiovascular diseases and improves physical fitness, personal autonomy, health, quality of life and life expectancy of people with SCI. However it is essential to be familiar with the persons particular characteristics in order to optimize their athletic performance and to prevent serious medical complications.

show abstract

Incidence of Autonomic Dysreflexia and Silent Autonomic Dysreflexia in Men With Spinal Cord Injury Undergoing Sperm Retrieval: Implications for Clinical Practice

Cited by 78 publications

References 27 publications

Autonomic dysreflexia severity during urodynamics and cystoscopy in individuals with spinal cord injury

Autonomic dysreflexia severity during urodynamics and cystoscopy in individuals with spinal cord injury

Sexual function and autonomic dysreflexia in men with spinal cord injuries: how should we treat?

Lesión medular y ejercicio físico: revisión desde una perspectiva deportiva

Contact Info

Product

Resources

About