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Neurogenic overactive bladder

Ana Claudia Paradella, André Ferraz de Arruda Musegante, Carlos Roberto Brites
Intravesical botulinum toxin A (BoNTA) injection has been widely used for the treatment of detrusor overactivity in patients with neurogenic bladder due to spinal cord injury who do not respond to conventional treatment. There is no consensus about antibiotic prophylaxis for this procedure. We conducted a retrospective analysis of medical records of adult patients with spinal cord injury who underwent detrusor BoNTA injection between January of 2007 and December of 2013 in a rehabilitation hospital. Occurrence of symptomatic urinary tract infection (UTI) was assessed in 3 groups in accordance with their use of antibiotics (prophylactic dosage, 3 days, more than 3 days) for the treatment of asymptomatic bacteriuria...
October 17, 2016: Brazilian Journal of Infectious Diseases
D Francomano, A Ilacqua, A Cortese, G Tartaglia, A Lenzi, M Inghilleri, A Aversa
PURPOSE: Men affected by multiple sclerosis often experience neurogenic overactive bladder (OAB), lower urinary tract symptoms and erectile dysfunction (ED). The aim of the study was to investigate modifications of urinary and sexual functions after administration of daily tadalafil (TAD) 5 mg. METHODS: Twenty men were enrolled in a single-blind, 4-week prospective study while 10 men without treatment served as controls. Primary outcomes were changes from baseline of International Prostate Symptom (IPSS), OAB questionnaire (OAB-q-short form) and International Index of Erectile Function (IIEF-5) scores...
October 17, 2016: Journal of Endocrinological Investigation
Charles Fattal, Claire Anquetil, Samer Abdelhamid
OBJECTIVE: To compare quality of life (QoL) in patients with spinal cord injury who underwent overactive detrusor treatment by Botulinum Toxin (BT) versus augmentation cystoplasty (AC). MATERIALS/PATIENTS AND METHODS: Prospective and descriptive study. Patients with refractory overactive bladder due to SCI were treated by at least 2 successive injections of BT or by AC. QoL was assessed using Qualiveen-30 (Q30). Clinical data and urodynamic parameters were collected and compared...
September 2016: Annals of Physical and Rehabilitation Medicine
Charles Joussain, Mélanie Popoff, Véronique Phé, Alexia Even, Laetitia Falcou, Emmanuel Chartier-Kastler, Brigitte Schurch, Pierre Denys
OBJECTIVE: Intradetrusor injection of onabotulinum toxin A (IDIBA) is the third-line therapy for patients with neurogenic detrusor overactivity (NDO). There is few evidence of long-term efficacy but no study assessed reasons for failure or abandonment of IDIBA and CISC (clean intermittent self-catheterization) combined strategy. We aimed to assess its long-term outcome in NDO management, and analyze failure and discontinuation. MATERIALS/PATIENTS AND METHODS: We retrospectively reviewed medical records of patients admitted in our neurourology department between 2001 and 2013...
September 2016: Annals of Physical and Rehabilitation Medicine
Laura Weglinski, Rebecca Haddad, Benoit Peyronnet, Xavier Game, Calin Ciofu, Gerard Amarenco
OBJECTIVE: Intradetrusorial injection of botulinum toxin A (IDBT) is a validated treatment for neurogenic and non-neurogenic refractory overactive bladder. In the elderly, muscarinic antagonists have many side effects, in particular in cognition. An alternative treatment is, for that reason, interesting in this frail population with multiple medication use. The question of efficacy is remaining. Indeed, bladder dysfunction is most of the time a multifactorial issue in the elderly. The objective of this study was to evaluate prospectively the efficacy and safety of IDBT in this population...
September 2016: Annals of Physical and Rehabilitation Medicine
Stephanie C Knüpfer, Susanne A Schneider, Mareike M Averhoff, Carsten M Naumann, Günther Deuschl, Klaus-Peter Jünemann, Moritz F Hamann
BACKGROUND: To assess the efficacy and safety of intradetrusor onabotulinumtoxinA (OnabotA) injection treatment in patients with neurogenic lower urinary tract dysfunction (NLUTD), especially for patients with Parkinson disease (PD). METHODS: PD patients refractory to oral antimuscarinic participated in an off-label use study and were evaluated prior and after 200 IU OnabotA injection into detrusor muscle, including trigone. Changes due to treatment were evaluated using bladder diaries, urodynamics, and questionnaires...
2016: BMC Urology
H Z Hu, N Granger, N D Jeffery
Management of persistent lower urinary tract dysfunction resulting from severe thoracolumbar spinal cord injury can be challenging. Severe suprasacral spinal cord injury releases the spinal cord segmental micturition reflex from supraspinal modulation and increases nerve growth factor concentration in the bladder wall, lumbosacral spinal cord, and dorsal root ganglion, which subsequently activates hypermechanosensitive C-fiber bladder wall afferents. Hyperexcitability of bladder afferents and detrusor overactivity can cause urine leaking during the storage phase...
September 2016: Journal of Veterinary Internal Medicine
Patrick C Campbell, Bronagh McDonnell, Kevin P Monaghan, Lauren Baysting, Oonagh Little, Karen D McCloskey
AIMS: To investigate the local, regulatory role of the mucosa on bladder strip contractility from normal and overactive bladders and to examine the effect of botulinum toxin A (BoNT-A). METHODS: Bladder strips from spontaneously hyperactive rat (SHR) or normal rats (Sprague Dawley, SD) were dissected for myography as intact or mucosa-free preparations. Spontaneous, neurogenic and agonist-evoked contractions were investigated. SHR strips were incubated in BoNT-A (3 h) to assess effects on contractility...
August 5, 2016: Neurourology and Urodynamics
Katarina Ivana Tudor, Ryuji Sakakibara, Jalesh N Panicker
The lower urinary tract (LUT) in health is regulated by coordinated multi-level neurological inputs which require an intact central and peripheral nervous system. Lower urinary tract dysfunction is, therefore, a common sequelae of neurological disease and the patterns of bladder storage and voiding dysfunction depend upon the level of neurological lesion. Evaluation includes history taking, bladder diary, urological examination when relevant, ultrasonography and urodynamic testing when indicated. Antimuscarinic agents are the first line treatment for patients with storage dysfunction...
July 11, 2016: Journal of Neurology
Masashi Yano, Ryuji Sakakibara, Fuyuki Tateno, Osamu Takahashi, Haruka Nakamura, Megumi Sugiyama, Lee Fang-Ching, Syuichi Kamijima, Naoto Kamiya, Hiroyoshi Suzuki
AIM OF STUDY: Urinary dysfunction in Creutzfeldt-Jakob disease (CJD) patients is attributed to functional incontinence, since they often have immobility and loss of motivation. In contrast, previously no urodynamic findings are available in CJD patients. CASE REPORT: We had 2 CJD patients who had urinary frequency and urinary retention. We performed urodynamics with the spouse's informed consent in order to explore the mechanism of urinary dysfunction in those cases...
October 2016: International Urology and Nephrology
T A T Marcelissen, M S Rahnama'i, A Snijkers, B Schurch, P De Vries
INTRODUCTION: Intravesical botulinum toxin (BoNT-A) is a safe and effective treatment for overactive bladder syndrome. There are many reports on the clinical experience with BoNT-A, especially in patients with neurogenic detrusor overactivity. The US Food and Drug Administration has recently approved its use for idiopathic overactive bladder (iOAB). Various studies have reported positive results for iOAB in the short-term. Yet little is known about the results after repeated BoNT-A injections...
June 7, 2016: World Journal of Urology
Sheng-Fu Chen, Chia-Hwei Chang, Hann-Chorng Kuo
Chornic spinal cord injury (SCI) will induce bladder urothelium dysfunction. This study investigated the therapeutic effects on urothelial dysfunction after repeated detrusor injections of onabotulinumtoxinA (BoNT-A) in SCI patients with neurogenic detrusor overactivity (NDO). Twenty chronic suprasacral SCI patients with NDO were enrolled. The patients received 300 U BoNT-A injection into the detrusor every six months. The urothelium was assessed by cystoscopic biopsy at baseline and six months after each BoNT-A treatment...
2016: Toxins
Ana Coelho, Raquel Oliveira, Francisco Cruz, Célia Duarte Cruz
Spinal cord injury (SCI) often leads to neurogenic detrusor overactivity (NDO) due to sprouting of sensory afferents on the lumbosacral spinal cord. NDO is characterized by high frequency of voiding contractions and increased intravesical pressure that may lead to urinary incontinence. The latter has been described as one of the consequences of SCI that mostly decreases quality of life. Bladder wall injections of botulinum toxin A (Onabot/A) are an effective option to manage NDO. The toxin strongly impairs parasympathetic and sensory fibers coursing the bladder wall...
May 25, 2016: Experimental Neurology
Hyeong Gon Kim, Hyoung Keun Park, Sung Hyun Paick, Woo Suk Choi
BACKGROUND: The aim of this study was to compare the two types of mid-urethral slings for stress urinary incontinence (SUI) with intrinsic sphincter deficiency (ISD). METHODS: This retrospective study included patients who underwent tension-free vaginal tape (TVT) procedure or transobturator tape (TOT) procedure by a single surgeon for SUI with ISD, defined as Valsalva leak point pressure (VLPP) < 60 cmH2O in a urodynamic study. Cases of neurogenic bladder, previous SUI surgery, and concomitant cystocele repair were excluded...
2016: PloS One
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
Juliette Hascoet, Andrea Manunta, Charlène Brochard, Alexis Arnaud, Mireille Damphousse, Hélène Menard, Jacques Kerdraon, Hubert Journel, Isabelle Bonan, Sylvie Odent, Benjamin Fremond, Laurent Siproudhis, Xavier Gamé, Benoit Peyronnet
CONTEXT: Bladder management in spina bifida patients relies on clean intermittent catheterization and oral antimuscarinics with a significant failure rate. The efficacy of intradetrusor injections of botulinum toxin has been confirmed in patients with spinal cord injury or multiple sclerosis but not in patients with myelomeningocele. OBJECTIVE: To conduct a systematic review of current evidence regarding the efficacy of intra-detrusor injections of Botulinum Toxin A (BTX-A) in spina bifida patients with neurogenic detrusor overactivity (NDO) refractory to antimuscarinics...
May 17, 2016: Neurourology and Urodynamics
Xuelin Zhou, Wai Ping Lam, Hong Chai Tang, Chi-Man Koon, Ling Cheng, Clara Bik-San Lau, Willmann Liang, Ping-Chung Leung
AIM: Ex vivo experiments showed that the water extract of Puerariae lobatae Radix (named Gegen in Chinese) induced detrusor relaxation. The aim of this study was to prove the in vivo efficacy of Gegen on improving detrusor overactivity and its possible synergism with darifenacin (a first-line muscarinic receptor-3 inhibitor) in spontaneously hypertensive rats (SHR), a rat model exhibiting symptoms of detrusor overactivity. METHOD: After daily oral administration of Gegen 30 (Gegen, 30mg/kg); Gegen 300 (Gegen, 300mg/kg); Low_Dar (darifenacin, 3mg/kg); High_Dar (darifenacin, 30mg/kg) Low_Dar+Gegen 30 or High_Dar+Gegen 30 for 3 weeks, bladder detrusor strips of the rats were isolated and assessed with different stimulators for the measurement of tonic and phasic contractile activities (including phasic amplitude and frequency)...
June 1, 2016: Phytomedicine: International Journal of Phytotherapy and Phytopharmacology
Omer Onur Cakir, Carol A Podlasek, Douglas Wood, Kevin E McKenna, Kevin T McVary
INTRODUCTION: The objective of this work is to examine if sensory innervation impacts lower urinary tract symptoms (LUTS). Onabotulinum toxin A (BoNTA) has been used for the treatment of overactive and neurogenic bladder and as a treatment for LUTS secondary to benign prostatic hyperplasia (BPH). The mechanism of how BoNTA impacts LUTS/BPH is unclear. In rats, BoNTA injection causes prostate denervation, apoptosis and atrophy. In clinical trials reduced prostate size and LUTS are observed inconsistently, suggesting a neurologic component...
June 2015: Andrology: Open Access
C Anquetil, S Abdelhamid, A Gelis, C Fattal
STUDY DESIGN: Cross-sectional study. OBJECTIVES: To compare quality of life (QoL) in patients with spinal cord injury (SCI) who underwent overactive detrusor treatment by botulinum toxin (BT) versus augmentation cystoplasty (AC). SETTING: France. METHODS: Prospective and descriptive study: Patients with a refractory overactive bladder due to SCI treated by at least two successive injections of BT or by AC. QoL was assessed using Qualiveen-30 (Q30)...
April 26, 2016: Spinal Cord
Hidehiro Kakizaki, Masafumi Kita, Masaki Watanabe, Naoki Wada
Non-neurogenic lower urinary tract dysfunction (LUTD) in children is very common in clinical practice and is important as an underlying cause of lower urinary tract symptoms, urinary tract infection and vesicoureteral reflux in affected children. LUTD in children is caused by multiple factors and might be related with a delay in functional maturation of the lower urinary tract. Behavioral and psychological problems often co-exist in children with LUTD and bowel dysfunction. Recent findings in functional brain imaging suggest that bladder bowel dysfunction and behavioral and psychiatric disorders in children might share common pathophysiological factors in the brain...
May 2016: Lower Urinary Tract Symptoms
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