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Neuropathic bladder

Armin Blesch
Beyond impaired motor and sensory function, neuropathic pain and loss of bladder control caused by spinal cord injuries (SCIs) can severely affect quality of life. In this issue of Cell Stem Cell, Fandel et al. (2016) show that transplanted human ESC-derived cells biased to produce inhibitory interneurons significantly improve pain and bladder function in rodent SCI models.
October 6, 2016: Cell Stem Cell
A C Wiestma, C R Estrada, P S Cho, M V Hollis, R N Yu
INTRODUCTION: Bladder augmentation is a common surgical intervention for neuropathic bladder dysfunction, and has conventionally been an open procedure. We present a robotic ileocystoplasty to demonstrate the feasibility of an entirely intracorporeal approach in a pediatric patient. METHODS: The patient was a 6 year old (18.5 kg) boy with a neurogenic bladder secondary to lumbar myelomeningocele. Urodynamics revealed a small capacity and poorly compliant bladder and he was incontinent between frequent catheterizations...
August 21, 2016: Journal of Pediatric Urology
K M Szymanski, R C Rink, B Whittam, J D Ring, R Misseri, M Kaefer, M P Cain
INTRODUCTION: The Kropp and Salle procedures have shown good short-term outcomes for managing neuropathic urinary incontinence. However, few studies have assessed their long-term results. OBJECTIVE: This study aimed to evaluate the long-term outcomes of Kropp and Salle procedures, including: dryness, secondary interventions for incontinence or complications, upper urinary tract changes, and use of urethral catheterizations. STUDY DESIGN: Consecutive patients undergoing Kropp and Salle procedures at the present institution (1983-2012) were retrospectively reviewed...
July 26, 2016: Journal of Pediatric Urology
Thomas M Fandel, Alpa Trivedi, Cory R Nicholas, Haoqian Zhang, Jiadong Chen, Aida F Martinez, Linda J Noble-Haeusslein, Arnold R Kriegstein
Neuropathic pain and bladder dysfunction represent significant quality-of-life issues for many spinal cord injury patients. Loss of GABAergic tone in the injured spinal cord may contribute to the emergence of these symptoms. Previous studies have shown that transplantation of rodent inhibitory interneuron precursors from the medial ganglionic eminence (MGE) enhances GABAergic signaling in the brain and spinal cord. Here we look at whether transplanted MGE-like cells derived from human embryonic stem cells (hESC-MGEs) can mitigate the pathological effects of spinal cord injury...
October 6, 2016: Cell Stem Cell
Sophie Jörgensen, Susanne Iwarsson, Jan Lexell
BACKGROUND: Many individuals with a spinal cord injury (SCI) have lived several decades with their injury, leading to a need for a deeper understanding of factors associated with healthy aging in people with long-term SCI. OBJECTIVES: To (1) describe secondary health conditions, activity limitations, and life satisfaction in older adults with long-term SCI, and to (2) investigate how sociodemographics, injury characteristics, and secondary health conditions are associated with their activity limitations and life satisfaction...
September 17, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Devesh Jalan, Neginder Saini, Mohammad Zaidi, Alexandra Pallottie, Stella Elkabes, Robert F Heary
OBJECTIVE In acute traumatic brain injury, decompressive craniectomy is a common treatment that involves the removal of bone from the cranium to relieve intracranial pressure. The present study investigated whether neurological function following a severe spinal cord injury improves after utilizing either a durotomy to decompress the intradural space and/or a duraplasty to maintain proper flow of cerebrospinal fluid. METHODS Sixty-four adult female rats (n = 64) were randomly assigned to receive either a 3- or 5-level decompressive laminectomy (Groups A and B), laminectomy + durotomy (Groups C and D), or laminectomy + duraplasty with graft (Group E and F) at 24 hours following a severe thoracic contusion injury (200 kilodynes)...
September 16, 2016: Journal of Neurosurgery. Spine
Subramanian Vaidyanathan, Azi Samsudin, Gurpreet Singh, Peter L Hughes, Bakul M Soni, Fahed Selmi
INTRODUCTION: Paraplegic patients are at greater risk of developing complications following ureteroscopic lithotripsy because of urine infection associated with neuropathic bladder, difficulties in access due to altered anatomy of urinary bladder and urethra, spinal curvature, spasticity, and contractures. We report the occurrence of large subcapsular hematoma following ureteroscopy and discuss lessons we learn from this case. CASE REPORT: A 48-year-old male patient with spina bifida underwent ureteroscopy with laser lithotripsy and ureteric stenting for left ureteric stone and staghorn calculus with hydronephrosis; laser lithotripsy was repeated after 3 months; both procedures were performed by a senior urologist and did not result in any complications...
2016: International Medical Case Reports Journal
Luis H Braga, Mandy Rickard, Forough Farrokhyar, Kizanee Jegatheeswaran, Natasha Brownrigg, Christine Li, Rahul Bansal, Jorge DeMaria, Armando J Lorenzo
INTRODUCTION: We evaluated if an animated bladder training video (BTV) was as effective as standard individual urotherapy (SU) in improving BBD symptoms. METHODS: Patients aged 5-10 years who scored >11 on the BBD Vancouver questionnaire were included in a non-inferiority randomized controlled trial. Children with vesicoureteral reflux, neuropathic bladder, learning disabilities, recent urotherapy and primary nocturnal enuresis were excluded. Patients were randomly assigned to receive either SU or BTV in clinic using centralized blocked randomization schemes...
August 25, 2016: Journal of Urology
Pankaj P Dangle, Omar Ayyash, Audry Kang, Carlton Bates, Janelle Fox, Heidi Stephany, Glenn Cannon
OBJECTIVE: To asses if cystatin c calculated GFR can reveal CKD not detected by creatinine-based calculations in a larger prospective cohort of children with MMC. Wheel chair bound meningomyelocele (MMC) patients frequently have low muscle mass, and assessing renal deterioration based on creatinine based glomerular filtration rate is imprecise. MMC patients are also at risk for end stage renal disease. METHODS: Prospectively enrolled patients with MMC underwent annual serum creatinine and cystatin c testing...
August 16, 2016: Urology
Kristina D Suson
In recent years, there has been increasing interest in transitional urology, or how to best prepare patients with major congenital urologic diseases, such as bladder exstrophy and neuropathic bladder, to manage their own health care with adult urologists. However, common pediatric urologic conditions may be encountered by the adult urologist with more regularity. This review focuses on three relatively common conditions which may be identified in childhood, the consequences from which a patient may seek help from an adult urologist: cryptorchidism, varicocele, and Klinefelter syndrome...
October 2016: Current Urology Reports
R G Frykberg, S M Cazzell, J Arroyo-Rivera, A Tallis, A M Reyzelman, F Saba, L Warren, B C Stouch, T W Gilbert
OBJECTIVE: The objective of this prospective, multicentre clinical study is to assess the application of MatriStem MicroMatrix (MSMM) and MatriStem Wound Matrix (MSWM) (porcine urinary bladder derived extracellular matrix) compared with Dermagraft (DG) (human fibroblast-derived dermal substitute) for the management of non-healing diabetic foot ulcers (DFUs). METHOD: A randomised, multicentre study was conducted at thirteen centers throughout the US. It was designed to evaluate the incidence of ulcer closure, rate of ulcer healing, wound characteristics, patient quality of life, cost-effectiveness, and recurrence...
July 2016: Journal of Wound Care
Bin Chiu, Huai-Ching Tai, Shiu-Dong Chung, Lori A Birder
Botulinum neurotoxin A (BoNT-A), derived from Clostridium botulinum, has been used clinically for several diseases or syndrome including chronic migraine, spasticity, focal dystonia and other neuropathic pain. Chronic pelvic or bladder pain is the one of the core symptoms of bladder pain syndrome/interstitial cystitis (BPS/IC). However, in the field of urology, chronic bladder or pelvic pain is often difficult to eradicate by oral medications or bladder instillation therapy. We are looking for new treatment modality to improve bladder pain or associated urinary symptoms such as frequency and urgency for patients with BPS/IC...
2016: Toxins
Anne J Wright, Mirna Haddad
Both non-invasive and invasive electroneurostimulation (ENS) modalities for bladder bowel dysfunction have been studied and reported in children. A summary of the proposed mechanism of actions and the more commonly used and recently reported techniques and outcomes are described. This includes transcutaneous electrical nerve stimulation, functional electrical nerve stimulation, intravesical electrical nerve stimulation, percutaneous tibial nerve stimulation and sacral neuromodulation in conditions including overactive bladder, enuresis, dysfunctional voiding, constipation, combined bladder bowel dysfunction and neuropathic bladder and bowel dysfunction...
May 27, 2016: European Journal of Paediatric Neurology: EJPN
Marta Simone, Tanuja Chitnis
Pediatric multiple sclerosis (PedMS) is a rare disease with a more severe prognosis compared to adult-onset MS. It remains a challenging condition to treat because of the highly inflammatory nature of the disease, the prominent cognitive issues, and the limited knowledge about the efficacy and safety of current available disease-modifying therapies. Over the past decade, there has been a dramatic increase in the number of drugs licensed for adult-onset MS and several of them, although not tested in PedMS, are currently being used off-label in this population...
August 2016: Current Treatment Options in Neurology
Huiyi H Chang, Leif A Havton
Detrusor underactivity (DU) is defined as a contraction of reduced strength and/or duration during bladder emptying and results in incomplete and prolonged bladder emptying. The clinical diagnosis of DU is challenging when present alone or in association with other bladder conditions such as detrusor overactivity, urinary retention, detrusor hyperactivity with impaired contractility, aging, and neurological injuries. Several etiologies may be responsible for DU or the development of an underactive bladder (UAB), but the pathobiology of DU or UAB is not well understood...
May 21, 2016: Experimental Neurology
Mahreen Pakzad, Youko Ikeda, Carly McCarthy, Darryl G Kitney, Rita I Jabr, Christopher H Fry
To measure the relative transcription of adenosine receptor subtypes and the contractile effects of adenosine and selective receptor-subtype ligands on detrusor smooth muscle from patients with neuropathic overactive (NDO) and stable bladders and also from guinea-pigs. Contractile function was measured at 37°C in vitro from detrusor smooth muscle strips. Contractions were elicited by superfusate agonists or by electrical field stimulation. Adenosine-receptor (A1, A2A, A2B, A3) transcription was measured by RT-PCR...
August 2016: Naunyn-Schmiedeberg's Archives of Pharmacology
C Alberti
To prevent problematic outcomes of bowel-based bladder reconstructive surgery, such as prosthetic tumors and systemic metabolic complications, research works, to either regenerate and strengthen failing organ or build organ replacement biosubstitute, have been turned, from 90s of the last century, to both regenerative medicine and tissue engineering.Various types of acellular matrices, naturally-derived materials, synthetic polymers have been used for either "unseeded" (cell free) or autologous "cell seeded" tissue engineering scaffolds...
January 2016: Il Giornale di Chirurgia
Michael W Carter, Kathia M Johnson, Jun Yeon Lee, Claire E Hulsebosch, Young Seob Gwak
BACKGROUND: The present study was designed to examine the functional recovery following spinal cord injury (SCI) by adjusting the parameters of impact force and dwell-time using the Infinite Horizon (IH) impactor device. METHODS: Sprague-Dawley rats (225-240 g) were divided into eight injury groups based on force of injury (Kdyn) and dwell time (seconds), indicated as Force-Dwell time: 150-4, 150-3, 150-2, 150-1, 150-0, 200-0, 90-2 and sham controls, respectively...
April 2016: Korean Journal of Pain
Roberto I Lopes, Armando Lorenzo
Neuropathic bladder usually causes several limitations to patients' quality of life, including urinary incontinence, recurrent urinary tract infections, and upper urinary tract damage. Its management has significantly changed over the last few years. The aim of our paper is to address some salient features of recent literature dealing with reconstructive procedures in pediatric and adolescent patients with lower urinary tract dysfunction.
2016: F1000Research
B Lee, N Featherstone, P Nagappan, L McCarthy, S O'Toole
INTRODUCTION: A large number of children with spina bifida develop a neuropathic bladder and this group of patients still forms the largest group of children who require urological management. Although there are published guidelines on the management of the neuropathic bladder, they are not specific to children. It is unsurprising, therefore, that the initial investigation, assessment and management of children with spina bifida vary considerably. The 2014 British Association of Paediatric Urologists (BAPU) meeting was devoted to the management of the neuropathic bladder...
April 2016: Journal of Pediatric Urology
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