Urodynamic practice in neuro-urological patients: techniques and clinical value

Madersbacher, H.; Dietl, Paul

doi:10.1038/sc.1984.27

Cited by 5 publications

(3 citation statements)

References 14 publications

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“…He noted DSD as inappropriate contraction or failure of relaxation of either the internal (smooth muscle) or external (striated muscle) urethral sphincter or both coincident with detrusor contraction, recording simultaneously the activity of the external urethral sphincter by EMG, and noting narrowing of the external sphincter zone by VCUG. Lastly, Madersbacher and Dietl [1984] points out that ''videography is the only method which is able to demonstrate function or dysfunction of the bladder neck . .…”

Section: Prior Reportsmentioning

confidence: 98%

Diagnostic discordance of electromyography (EMG) versus voiding cystourethrogram (VCUG) for detrusor‐external sphincter dyssynergy (DESD)

Patel

Tharian

et al. 2005

Neurourology and Urodynamics

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Section: Prior Reportsmentioning

confidence: 98%

Diagnostic discordance of electromyography (EMG) versus voiding cystourethrogram (VCUG) for detrusor‐external sphincter dyssynergy (DESD)

Patel

Tharian

et al. 2005

Neurourology and Urodynamics

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“…The use of extensive equipment can be of great advantage and subtle investiga tions are often necessary to make a complete evaluation in specific cases (Madersbacher and Dietl 1984). For routine evaluations, a well trained and experienced investigator will get a wealth of information from a urodynamic study done with a one or two channel cystometer and with EMG of the urethral sphincter.…”

Section: Paraplegiamentioning

confidence: 99%

Urology in spinal cord injured patients

Wyndaele

1987

Spinal Cord

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Neuro-urology and urodynamics have, during the last 10 years, grown to become a major part of urological management and practice. In this evolution, the spinal cord injured patient has often been the model for the development of investi gation techniques, methodology and treatment. The growing understanding of what is happening in the lower urinary tract of spinal men, made the management of the bladder dysfunction in these patients more accurate. As a direct result of this, urinary complications have become less frequent and urological pathology is no longer the most important cause of death after spinal cord injury. Although this must be a reason for contentment, one should be aware that this result was only obtained by very high standards of treatment, and by an intensive longterm follow-up. Without a doubt any lapse in management would soon lead to new disasters. Indeed, today we are no nearer to the solution of producing neuro logical recovery: the dysfunction of the lower urinary tract continues to be one of the most hazardous of neurological deficits seen after spinal cord injury and its possible disturbance of renal function is still directly life-threatening.The actual urological management can be considered in three distinct periods: a period of bladder drainage in the acute post-injury phase when the lower urinary tract has no active function because of spinal shock; the period of bladder re-education when a new and safe way of regular bladder emptying has to be obtained; the urological follow-up which has to be thorough and lifelong.Treatment of urological complications may be necessary in each of these periods.The value of intermittent catheterisation in the period of spinal shock has been well documented. Without a doubt this method is the best one, as it leaves the bladder without foreign material, provides its regular complete emptying and results in very few complications if properly performed. In the context of comprehensive management in a spinal unit, the non-touch technique done by a catheter team, will most certainly give a maximum of guarantee for the bladder wall to remain in a favourable condition while awaiting its activity to restart (Bedbrook 198 1). Recently a renewed interest has been shown in fine bore suprapubic cystostomy. This method has proved to be useful and safe in the first few days post-injury when extensive fluctuations of diuresis are seen which could lead to bladder overdistention between con secutive catheterisations.As soon as patients recover from spinal shock, a thorough evaluation of the lower urinary tract function has to be done. In those with a complete spinal lesion, the value of a clinical neurological investigation is still very important.

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“…In order to assess the urinary tract in these individuals video-urodynamic investigation is required. [10][11][12] Managing stress urinary incontinence in females with spinal cord injury is challenging. It requires careful assessment and experience in managing spinal injured patients.…”

Section: Introductionmentioning

confidence: 99%

Management of stress urinary incontinence in spinal cord injured female patients with a mid-urethral tape – a single center experience

Sakalis

Floyd

Guy

et al. 2017

The Journal of Spinal Cord Medicine

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Context/Objective: Stress urinary incontinence (SUI) affects the quality of life of females with spinal cord injury (SCI), has a negative impact on functional independence and disturbs their psychosocial interaction. Our aim was to assess the efficacy of mid-urethral tapes (MUT) in managing stress urinary incontinence in this population. Design: Retrospective cohort study. Participants: SCI females with upper motor neuron lesion and urodynamically proven stress or mixed urinary incontinence that was treated with a mid-urethral tape and followed up for at least 12 months. Interventions: Mid-urethral tapes such TVT, TOT and mini-Arc. Patient reported outcomes based on the daily use of pads and ICIQ modular questionnaire scores. Outcome measures: The primary endpoint was defined as the success rate of MUT surgery in managing stress incontinence at 12. The secondary endpoints included the improvement rate at 12 months, the complication rates and the need for additional treatments. Results: 38 females were studied. At 12 months the overall patient reported success rate was 52.6%. 16% reported significant improvement. 68.4% felt the quality of life to improve. Nine patients develop tape related complications (five de novo urgency, one vaginal extrusion, one frequent dysreflexia and one worsening of incontinence). Conclusion: Mid-urethral tapes are effective in the management of stress urinary incontinence in female patients with spinal cord injury. There are demonstrable improvements in both continence and quality of life.

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Urodynamic practice in neuro-urological patients: techniques and clinical value

Cited by 5 publications

References 14 publications

Diagnostic discordance of electromyography (EMG) versus voiding cystourethrogram (VCUG) for detrusor‐external sphincter dyssynergy (DESD)

Diagnostic discordance of electromyography (EMG) versus voiding cystourethrogram (VCUG) for detrusor‐external sphincter dyssynergy (DESD)

Urology in spinal cord injured patients

Management of stress urinary incontinence in spinal cord injured female patients with a mid-urethral tape – a single center experience

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