Neurogenic Detrusor Overactivity in Patients With Spinal Cord Injury: Evaluation and Management

Sahai, Amit; Cortes, Eduardo; Seth, Jai; Khan, Muhammad Shamim; Panicker, Jalesh N.; Kelleher, Cornelius; Kessler, Thomas M.; Fowler, Clare J.; Dasgupta, Prokar

doi:10.1007/s11934-011-0221-1

Cited by 34 publications

(24 citation statements)

References 65 publications

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“…In cases of SC transection above the lumbosacral SC, which preserves the parasympathetic and sensory spinal centers in the sacral SC, synaptic reorganization leads to the appearance of involuntary bladder contractions during bladder filling designated by neurogenic detrusor overactivity (NDO) [78][79][80] according to terminology adopted by International Continence Society [81]. Nevertheless the coordination between bladder contractions and urethral…”

Section: Biomarkers Of Lower Urinary Tract Dysfunction After Spinal Cmentioning

confidence: 99%

Biomarkers of spinal cord injury and ensuing bladder dysfunction

Cruz

Coelho

Antunes-Lopes

et al. 2015

Advanced Drug Delivery Reviews

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Section: Biomarkers Of Lower Urinary Tract Dysfunction After Spinal Cmentioning

confidence: 99%

Biomarkers of spinal cord injury and ensuing bladder dysfunction

Cruz

Coelho

Antunes-Lopes

et al. 2015

Advanced Drug Delivery Reviews

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“…Therefore, urinary retention can commonly occur, and urinary incontinence does not generally occur unless overdistention with overflow exists [24]. Clean intermittent catheterization (CIC) or transurethral or suprapubic indwelling catheterization is the optimal management in this period [27,28]. When spinal shock resolves, recovery of detrusor contractility is possible and is often heralded by the presence of incontinence [24].…”

Section: Clinical Characteristics Of Lutd With Neurological Disordersmentioning

confidence: 99%

“…There are a number of management options for these patients; however, a single, optimal treatment is not yet available. Currently, only combination treatment can achieve maximal therapeutic effects [27,59-61]. …”

Section: Treatmentmentioning

confidence: 99%

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Management of Lower Urinary Tract Dysfunction in Patients with Neurological Disorders

2012

Korean J Urol

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The proper performance of the lower urinary tract is dependent on an intact neural innervation of the individual structures involved. Therefore, any congenital neurological anomalies, diseases, or lesions of the central, peripheral, or autonomic nervous systems can result in lower urinary tract symptoms. Lower urinary tract dysfunction (LUTD) secondary to neurological disorders can significantly reduce quality of life (QoL) and may also give rise to serious complications and psychological and social sequelae. The goals of management of LUTD in patients with neurological disorders are to prevent serious complications and to improve the patient's QoL. Understanding the physiology and pathophysiology of micturition is critical to selecting appropriate treatment options. This article provides an overview of the clinical characteristics, diagnosis, and management of LUTD in patients with certain central and peripheral neuropathies and common lesions.

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“…Although the treatment of DO is currently well defined and consensus-driven–with antimuscarinic drugs as the first-line treatment–its prevention has rarely been explored [1,2]. …”

Section: Introductionmentioning

confidence: 99%

Early Fesoterodine Fumarate Administration Prevents Neurogenic Detrusor Overactivity in a Spinal Cord Transected Rat Model

Biardeau¹,

Przydacz²,

Aharony³

et al. 2017

PLoS ONE

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BackgroundIn spinal cord injury, onset of detrusor overactivity (DO) is detrimental for quality of life (incontinence) and renal risk. Prevention has only been achieved with complex sophisticated electrical neuromodulation techniques.PurposeTo assess the efficacy of early fesoterodine fumarate (FF) administration in preventing bladder overactivity in a spinal cord transected (SCT) rat model.Methods33 Sprague-Dawley rats were allocated to 6 groups–Group 1: 3 normal controls; Group 2: 6 SCT controls; Group 3: 6 SCT rats + FF 0.18 mg/kg/d; Group 4: 6 SCT rats + FF 0.12 mg/kg/d; Group 5: 6 SCT rats + FF 0.18 mg/kg/d + 72-h wash-out period; Group 6: 6 SCT rats + FF 0.12 mg/kg/d + 72-h wash-out period. SCT was performed at T10. FF was continuously administered. Cystometry was undertaken 6 weeks after SCT in awake rats recording intermicturition pressure (IMP), baseline pressure, threshold pressure (Pthres) and maximum pressure (Pmax). Normal controls and SCT controls were initially compared using the Mann-Whitney U tests in order to confirm the SCT effect on cystometric parameters. The comparisons in cystometric and metabolic cage parameters between SCT controls and treated rats were done using post-hoc Dunn’s tests for Kruskal-Wallis analysis. Statistical testing was conducted at the two-tailed α-level of 0.05.ResultsPressure parameters were significantly higher in SCT control group compared to normal controls. Six weeks after SCT, IMP was significantly lower in low dose treated group than in SCT controls. Pmax was significantly lower in 3 treated groups compared to SCT controls. Pthres was significantly lower in full time treated groups than in SCT controls.ConclusionEarly administration of FF modulates bladder overactivity in a SCT rat model. Whereas short-term prevention has been demonstrated, the long-term should be further analyzed. Clinical application of these results should confirm this finding through randomized research protocols.

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Neurogenic Detrusor Overactivity in Patients With Spinal Cord Injury: Evaluation and Management

Cited by 34 publications

References 65 publications

Biomarkers of spinal cord injury and ensuing bladder dysfunction

Biomarkers of spinal cord injury and ensuing bladder dysfunction

Management of Lower Urinary Tract Dysfunction in Patients with Neurological Disorders

Early Fesoterodine Fumarate Administration Prevents Neurogenic Detrusor Overactivity in a Spinal Cord Transected Rat Model

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