Document Detail


Significance of low compliance bladder in cauda equina injury.
MedLine Citation:
PMID:  12483499     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY DESIGN: Prospective investigation using serial urodynamic studies.
OBJECTIVE: To evaluate type of neurogenic bladder and to observe changes of autonomous detrusor contraction (ADC) after the normalization of the compliance and capacity of the bladder in cauda equina injury.
SETTING: Spinal Cord Injury Unit, Yonsei Rehabilitation Hospital, Seoul, Korea.
METHODS: Urodynamic studies were performed in 50 patients with complete cauda equina injury from trauma with an infusion ratio of 30 ml/min. Findings of urodynamic studies and clinical features of patients with low compliance were compared with those of the normal compliant patients. Fourteen patients with low compliance received oral administration of oxybutynin and propiverine and intravesical instillation of oxybutynin to increase the compliance and capacity of the bladder, and follow-up urodynamic studies to monitor the change were undertaken.
RESULTS: Bladder compliance was decreased in 14 (28%) patients and normal in 36 (72%) patients. There was a significantly long time interval between the onset of injury and the initiation of rehabilitative treatment in the neurogenic bladder group with low compliance when compared to those of the normal compliance group (P < 0.05). Clean intermittent catheterization was used as the voiding method, significantly less than the normal compliance group (P < 0.05). ADC was observed in six out of fourteen patients with low compliance neurogenic bladder, but none in the normal compliance group. Upon the completion of conservative treatment, ADC disappeared in four patients whose compliance and capacity of the bladder were normalized on follow-up urodynamic studies.
CONCLUSION: ADC was only observed in the low compliant bladder and as ADC disappeared when compliance and capacity of the bladder was normalized; low compliance appeared to be the main cause of ADC. In addition, this study supports that the maintenance of compliance of the bladder may be the most important factor in the management of neurogenic bladder.
Authors:
J C Shin; C-i Park; H J Kim; I Y Lee
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Spinal cord     Volume:  40     ISSN:  1362-4393     ISO Abbreviation:  Spinal Cord     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2002-12-16     Completed Date:  2003-01-30     Revised Date:  2011-06-06    
Medline Journal Info:
Nlm Unique ID:  9609749     Medline TA:  Spinal Cord     Country:  England    
Other Details:
Languages:  eng     Pagination:  650-5     Citation Subset:  IM    
Affiliation:
Department of Rehabilitation Medicine and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seodaemoon Gu, Seoul, Korea.
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MeSH Terms
Descriptor/Qualifier:
Administration, Intravesical
Administration, Oral
Adult
Benzilates / administration & dosage,  pharmacology
Cauda Equina
Compliance*
Female
Humans
Male
Mandelic Acids / administration & dosage,  pharmacology
Muscle Contraction / drug effects*,  physiology
Parasympatholytics / pharmacology
Prospective Studies
Spinal Cord Injuries / complications,  physiopathology*
Urinary Bladder, Neurogenic / drug therapy,  etiology,  physiopathology*
Urodynamics / drug effects,  physiology*
Chemical
Reg. No./Substance:
0/Benzilates; 0/Mandelic Acids; 0/Parasympatholytics; 5633-20-5/oxybutynin; 60569-19-9/propiverine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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