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At least 19 recordsLinked to original sources
PubMed2002

Neurogenic bladder, neurogenic bowel, and sexual dysfunction in people with spinal cord injury.

The purpose of this article is to review the literature related to the effects of spinal cord injuries on genitourinary, gastrointestinal, and sexual function. These important areas of function are profoundly affected by spinal cord injuries, with the effects of injury being dependent on the specific level and degree of neurologic dysfunction. Our ability to manage neurogenic bladder dysfunctions and neurogenic bowel dysfunctions has improved over the past few years; however, in general the techniques used have not significantly changed. In contrast, a significant amount of new information has been made available regarding the effects of specific neurologic injuries on sexual response, particularly female sexual response. Moreover, techniques to remediate erectile dysfunction and infertility in the male have vastly improved the fertility potential of men with spinal cord injuries. Further research is warranted in all of these areas.

Fecal Incontinence↗
PubMed1994

Simultaneous measurement of cystometry and diuresis renography during full and empty bladder in neurogenic bladder patients: a preliminary report.

In 9 patients (4 male and 5 female; mean 24.7 years old) with neurogenic bladder dysfunction, diuresis renography and water filling cystometry were simultaneously monitored with a full and empty bladder, and findings of diuresis renography with a full bladder were compared with those of diuresis renography with an empty bladder. According to O'Reilly's classification, findings of diuresis renography with a full bladder were significantly worse than those of diuresis renography with an empty bladder, regardless of cystometry patterns and bladder compliances. Although every kidney without hydronephrosis on intravenous pyelogram showed normal diuresis renography with an empty bladder, some kidneys with hydronephrosis showed an obstructive pattern even with an empty bladder. These results suggest that in some patients with neurogenic bladder dysfunction, deterioration of the upper urinary tract occurs more easily with a full than with an empty bladder, regardless of bladder pressure and bladder compliance.

Adult↗
PubMed1988

[Clinical effects of oxybutynin hydrochloride in the treatment of unstable bladder and overactive neurogenic bladder: a long-term clinical trial].

Clinical effects and therapeutic usefulness of oxybutynin hydrochloride were evaluated in a long-term clinical trial on patients with unstable bladders and neurogenic bladders. Of the 46 patients entered into the trial, 37 were those diagnosed with an unstable bladder and 9 with a neurogenic bladder with overactive detrusor. In 37 of the cases (80%), the period of drug administration reached up to 12 weeks and in 16 cases (34%) the drugs were administered for more than 24 weeks. The average administration period was 165.9 days. The average total given dose was 1776.9 mg and average dose per day was 10.7 mg. Excellent and good responses were obtained in 76.3, 88.9 and 69.6% at 12 and 24 weeks after start of administration and at the time of discontinuing the drug, respectively. The cystometric changes at pre- and post-administration were evaluated on 23 cases and revealed a significant increase in volume at first sensation and maximum desire to void. Maximum resting intravesical pressure was significantly declined and uninhibited detrusor contractions were significantly suppressed. Side effects were noted in 11 of the 46 cases (23.9%), most of which were well tolerated by the patients. In 4 cases the drug had to be discontinued because of the side effects. Dry mouth was the most common side effect, occupying almost half of the incidents. No significant abnormality was noted on blood laboratory data, blood pressure or heart rate, following the drug administration. In one case slight increase in serum glutamic-oxalacetic transaminase and glutamic-pyruvic transaminase was encountered, but its relationship with the drug was obscure. The clinical usefulness of this drug (excellent and good) was 78.9, 88.9 and 69.6% at 12 and 24 weeks after start of administration, and at the time of drug discontinuation, respectively. The present long-term trial proved that oxybutynin hydrochloride is an exceedingly effective and safe agent for clinical management of unstable bladder and overactive neurogenic bladder.

Adolescent↗
PubMed1976

Oxybutynin in bladder spasm, neurogenic bladder, and enuresis.

Oxybutynin chloride (Ditropan), a tertiary amine possessing anticholinergic and papaverine-like, direct muscular antispasmodic effects, has been used in controlled clinical studies in patients with neurovesical reflex activity, uninhibited bladders, enuresis, and primary muscle spasm. The cystometrically documented, synergistic, anticholinergic, and muscle relaxant activity of oxybutynin observed in these studies indicates that the drug can be highly effective in the management of reflex neurovesical dysfunction, enuresis, and bladder spasm.

Adult↗
PubMed2000

Concomitant presence of bladder cancer and neurogenic bladder in a patient with HTLV-1 carrier: a case report.

We describe a case of an HTLV-1 carrier who developed bladder cancer and neurogenic bladder. HTLV-1 is thought to alter host immune function and to contribute to the development of other malignancies. It is also sometimes reported that urinary symptoms precede pyramidal symptoms in patients with HAM. To our knowledge, concomitant presence of bladder cancer and neurogenic bladder in an HTLV-1 carrier has not been previously reported.

Carrier State↗
PubMed1990

[Bladder augmentation in three patients with contracted bladder caused by neurogenic bladder].

Three patients with contracted bladder caused by neurogenic bladder underwent ileocystoplasty. The primary diagnosis was meningomyelocele for all of them. The operative procedure adopted was Goodwin's Cup-patch method. All cases have obtained increased bladder capacity with improvement of bladder compliance and have been free from urinary incontinence. They were followed up by using clean intermittent self catheterization. Ileocystoplasty combined with clean intermittent self catheterization offers a successful method in patients with contracted bladder caused by neurogenic bladder.

Adult↗
PubMed2003

Long-term urodynamics followup of bladder augmentation for neurogenic bladder.

PURPOSE: Augmentation enterocystoplasty is well tolerated by patients with neurogenic bladder in whom conservative therapy has failed. However, few studies exist on long-term urodynamic evaluation of these patients. We assessed the clinical and urodynamic outcomes of patients with neurogenic bladder treated with augmentation enterocystoplasty with at least 4 years of followup. MATERIALS AND METHODS: A total of 26 patients with neurogenic voiding dysfunction underwent augmentation enterocystoplasty alone or in conjunction with various continence or antireflux techniques. Clinical outcomes regarding incontinence, medications, catheterization schedule, subsequent interventions, bowel function and patient satisfaction were addressed. Urodynamic evaluation was performed to assess the long-term durability of bladder augmentation. RESULTS: Mean followup was 8.0 years (range 4 to 13). All but 1 patient (96%) in our series had near or complete resolution of urinary incontinence. Mean total bladder capacity +/- SD increased from 201 +/- 106 to 615 +/- 204 ml. (p <0.001) and mean maximum detrusor pressure decreased from 81 +/- 43 to 20 +/- 12 cm. H O (p <0.01). Mean interval between catheterizations was 5 hours, with volumes ranging from 314 to 743 ml. Only 2 patients (8%) needed a low dose of oxybutynin postoperatively to maintain continence consistently. Of the 26 patients 23 (88%) reported no significant change in bowel function and nearly all patients expressed extreme satisfaction with urological management. A subsequent urological procedure was required in 12 patients (46%) at a mean of 4.4 years after initial surgery.(2) CONCLUSIONS: Bladder augmentation provides durable clinical and urodynamic improvement for patients with neurogenic bladder dysfunction refractory to conservative therapy. Furthermore, there is a high level of patient satisfaction with bladder augmentation.

Adolescent↗
PubMedDate not supplied

Clinical patterns of neurogenic bladder.

The neurogenic bladder represents a vesical dysfunction secondary to a congenital or acquired neurologic lesion, spinal dysraphism being the most common cause in pediatric age. According to the lesion level and severity, neurogenic bladder can be hypertonic hyperreflexic, hypotonic hyporeflexic or of mixed type characterized by different clinical and urodynamic patterns and the potential cause of nephrourologic complications. These types of neurogenic bladder require diversified treatments as anticholinergic drugs, clean intermittent catheterization and antibiotic prophylaxis, separately or in various combinations. Close follow-up of children is necessary to control and prevent the onset of complications with changes in medical therapy or surgical treatment if required.

Child↗
PubMed1991

Neurogenic bladder simplified.

Neurogenic bladder dysfunction, if not properly diagnosed and treated, can lead to rapid deterioration of renal function by compromise of the upper urinary tracts. Two major categories of neurogenic bladder (detrusor hyperreflexia areflexia) have been discussed including the pathophysiology of the voiding dysfunction and the typical radiographic findings. Radiologists studying patients with suprasacral cord lesions should be aware of the causes, symptoms, and treatment of autonomic dysreflexia. Although video urodynamics is the state-of-the-art modality for evaluating complex or refractory neurogenic bladder, the practicing radiologist with an understanding of this condition can detect many radiographic changes in the lower urinary tract that suggest neurogenic dysfunction of various types.

Female↗
PubMed2000

[Selected secondary reconstructive procedures for improvement of urinary incontinence in bladder exstrophy and neurogenic bladder dysfunction in childhood].

Partial or complete urinary and stool incontinence due to malformation of the genito-urinary tract and the pelvic floor despite of several operative reconstructions is the most important handicap in the patients life. Often this problems seems to be unsoluble. In recent time we secondarily reconstructed 7 patients suffering from urinary incontinence: 1 girl and 4 boys with bladder ekstrophy; 1 boy with a complex anomaly with menigomyelocele, sinus urogenitalis, single kidney with vesicorenal reflux and neurogene bladder; 1 boy with complex anomaly of the pelvis and the lower limbs with duplication of the bladder with an ekstrophic left part. All patients underwent multiple operative trials of reconstruction. Until that time all patients suffered from complete urinary incontinence. At the age of 5 to 14 years we performed the secondary reconstruction: bladder-neck-plasty and ileumaugmentation (3 patients), closure of the bladder-neck, ileumaugmentation and a continent appendicostoma (Mitrofanoff's method)), Mainz-I-pouch and a continent appendicostoma respectively ileostoma (Monti's technique) (2 patients), Mainz-II-pouch. With a normal bladder-capacity all patients are completely continent postoperatively; one patient has regained partial continence. The emptying of the bladder is carried out by clean intermittent catheterism (CIC) with the exception of the one patient with the Mainz-II-pouch. Even in patients with complex anomalies of the pelvic floor and the genitourinary tract complete urinary continence is possible in consequence of recently developed operative techniques. Because of a high rate of complications we reject the primary use of artificial sphincter systems for children.

Abnormalities, Multiple↗
PubMed2003

[Neurogenic bladder caused by hemorrhagic necrotizing myelitis].

OBJECTIVES: To report one case of flank pain irradiated to lower extremities, progressive paresthesias and functional difficulty leading to functional impotence of the lower limbs, and difficult voiding. METHODS: Neurologic physical examination showed abolished osteotendinous reflexes, indifferent plantar, L1 hypoesthesia, L3 anesthesia, and lower limbs hypotony. Multiple complementary exams were performed to get the final diagnosis of hemorrhagic necrotizing myelitis by MRI, after differential diagnosis with cavernous haemangioma. We performed a bibliographic search in Pub-Med (MEDLINE) using the terms "bladder, neurogenic (MESH) and myelitis (MESH)". Most publications correspond to case reports and prospective studies of cases of acute myelitis of different etiologies (arteriovenous malformations, multiple sclerosis, neoplasia, sarcoidosis, HIV infection, spinal cord compression,...) reviewing the diagnostic and therapeutic procedures. RESULTS: Neurologic examination, imaging studies and analytical determinations in cerebrospinal fluid (CSF) and blood were conclusive to confirm the level of the lesion and the most probable etiology in both the present case and those provided by the literature. Urodynamic study showed a neurologic bladder both at 4 and 24 months, being this the main sequel in our patient. The clinical repercussion derived from the level of the lesion improved in relation to walking and muscular balance, but the voiding condition persisted with bladder hyperreflexia and dyssynergia. CONCLUSIONS: The clinical picture alerts about spinal involvement. Radiological tests, supported by analysis, allow to identify the level of the lesion, and in many cases the cause. Bladder dysfunction is common in acute myelopathies, and urodynamic studies help to label the picture and manage it.

Adolescent↗
PubMed1980

Treatment of neurogenic bladder dysfunction in multiple sclerosis by ultrasound-controlled bladder training.

Neurogenic bladder dysfunction, the main cause of chronic urinary tract infections in multiple sclerosis (MS), is efficiently treated by bladder training with ultrasound control of the residual urine. However, the beneficial effects of bladder training in the hospital are often lost within a short time when the patient returns to his home. Reexamination at home of 97 MS patients with increased residual urine and/or chronic urinary tract infections showed that the group which claimed to continue bladder training at home had significantly less residual urine at home than the group which did not continue bladder training at home. The residual urine decreased from 210 ml on average to almost normal while the patients did bladder training in the hospital, but the volume nearly doubled within a short time at home. Thus, more decentralized rehabilitation by family members, volunteer personnel or local nurses is necessary. Decentralized symptomatic therapy is the most efficient treatment of MS at present. Family members. volunteers, and local nurses, however, need training. Without these improvements in decentralized rehabilitation the hospital treatment of MS is of little benefit because urinary tract infection quickly recurs at home. For efficient bladder training the patient needs feedback regarding the residual urine; this can be provided with minimum risk by ultrasound sonocystography. In those rare cases in which bladder training does not work, intermittent catheterization must be carried out by the patients or their families, volunteer personnel or a local nurse. A continuous indwelling catheter should not be used. antibiotic treatment should be applied only on the basis of a precise bacteriological diagnosis.

Adult↗
PubMedDate not supplied

[Guidelines in the treatment of neurogenic bladder].

A neurogenic bladder is understood as a bladder with a voiding disfunction caused by a congenital or acquired neurologic disease. This paper focuses on three situations in clinical practice in which the neurologic disease affects the normal function of the bladder and sphincter. A physiopathological review is made and the guidelines for the correct follow-up and urologic treatment are suggested.

Cerebrovascular Disorders↗