Neurogenic bladder is a condition characterized by lack of bladder control related to nerve damage. While the condition is not genetic, the birth defect spina bifida may trigger it in some individuals.
The Facts
The Cleveland Clinic describes neurogenic bladder as a potential complication of any disease or physical trauma that impacts the nerves controlling bladder function. Depending on the individual, neurogenic damage can trigger either overactive or underactive bladder function.
Spina Bifida
Children’s Hospital Boston cites spina bifida as a common underlying cause of neurogenic bladder in children. This occurs when spinal changes caused by the birth defect disrupt the normal signal path of nerves related to bladder control.
Additional Causes
Children’s Hospital Boston and the Medline Plus identify additional underlying causes of neurogenic bladder that include spinal cord injury, Alzheimer’s disease, pelvic or central nervous system tumors, multiple sclerosis, diabetes and stroke recovery.
Diagnosis
Doctors diagnose neurogenic bladder through a combination of physical examination, medical history, urine testing and studies of bladder volume and pressure, according to Children’s Hospital Boston.
Treatments
Medline Plus notes potential treatments for neurogenic bladder that include medications for overactive or underactive bladder, antibiotics to address infections and exercises to strengthen pelvic floor muscles.
source: ehow
Last Updated: July 27, 2020 by uabadmin
Ultrasound imaging of sacral reflexes.
Ultrasound imaging of sacral reflexes.: “
Ultrasound imaging of sacral reflexes.
Urology. 2006 Sep;68(3):652-4
Authors: de Jong TP, Klijn AJ, Vijverberg MA, de Kort LM
OBJECTIVES: To investigate the reliability of examination of the guarding reflex of the pelvic floor by dynamic perineal ultrasonography in children with bladder dysfunction and in controls. METHODS: A total of 40 patients with nonneurogenic bladder/sphincter dyssynergia, 40 with spina bifida, and 40 controls underwent a dynamic ultrasound examination of the pelvic floor while coughing and while being tapped on the abdominal wall. The reflex action of the puborectal muscle in females, and the combined action of the puborectal muscle and external sphincter muscle in males, were recorded. RESULTS: Of the 40 patients with nonneurogenic bladder/sphincter dyssynergia, 38 had a normal reflex action of the puborectal muscle during the abdominal tap and 36 had a normal reflex action when coughing. Two of these patients had unexplained underactive bladder syndrome and were using clean intermittent catheterization, and two could not be assessed because of hypermobility of the bladder neck when coughing but had a normal reaction during abdominal tapping. Of the 40 patients with spina bifida, none had puborectal activity during coughing and 5 had some puborectal activity during tapping. Of the 40 controls, 39 had normal reflex activity during both coughing and tapping. CONCLUSIONS: The question of whether a child has nonneurogenic or neuropathic bladder/sphincter dysfunction is often difficult to answer on the basis of urodynamic studies alone. Dynamic perineal ultrasound recording of the S2-S4 reflex arches provides reliable additional information and is noninvasive to the patient.
PMID: 16979732 [PubMed – indexed for MEDLINE]
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Last Updated: July 27, 2020 by uabadmin
Magnet to the Scrotum! Urovalve Surinate Bladder Management System Ready To Go On Trial in U.S.
Magnet to the Scrotum! Urovalve Surinate Bladder Management System Ready To Go On Trial in U.S.: “
Urovalve, Inc. of Newark, N.J. has announced that the FDA has granted an Investigational Device Exemption (IDE) approval for the company’s Surinate Bladder Management System, allowing Urovalve to conduct a clinical study for the device in the United States. The Surinate system consists of a device inserted into the urethra that bridges the bladder neck, prostrate and external sphincter and provides a valved connection between the bladder and the bulbous urethra. The valve is magnetically controlled and can be activated remotely by the wearer by using a hand held magnet to self-regulate flow. When the hand held switching magnet is brought within 3 – 4 centimeters of the check valve magnet, it draws the check magnet away from the valve seat, permitting urine to flow out through the urethra. It is used for managing problems such as urinary retention and incontinence and can stay in place for 28 days.
Press release: Urovalve Granted IDE Approval by FDA to Conduct Clinical Study of Surinate® Bladder Management System…
Homepage: Urovalve…
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Last Updated: July 27, 2020 by uabadmin
Incontinence Detector Broadcasts The State of Your Pants
Incontinence Detector Broadcasts The State of Your Pants: “
An Australian company called Simavita is releasing an incontinence detection device to be used in nursing homes across New South Wales. The SIMsystem uses a strip that detects liquid and a cellular device to send a note to a nursing station or a care provider.
Product page: SIMsystem…
More from Australian Associated Press: Electronic underpants come to NSW…
(hat tip: Engadget)
Last Updated: July 27, 2020 by uabadmin
Assessment of urethral resistance at external sphincter zone during voiding by static withdrawal urethrometrogram.
Assessment of urethral resistance at external sphincter zone during voiding by static withdrawal urethrometrogram.: “
Assessment of urethral resistance at external sphincter zone during voiding by static withdrawal urethrometrogram.
Urol Int. 1984;39(6):327-31
Authors: Miyagawa I
We investigated the intraurethral pressure changes at the external sphincter zone during voiding act and during an attempt to contract the anal sphincter on 26 neurologically intact subjects (normal group) and 12 cases after intrapelvic surgery (6 after amputatio recti and 6 after radical hysterectomy) (disturbed group). During voiding the pressure was decreased in 25 of 26 cases of the normal group, but was increased in 11 of 12 cases of the disturbed group. In contracting the anal sphincter, urethral pressure rose in all cases of both normal and disturbed groups. A significant positive correlation (p less than 0.01) was found in the urethral pressure changes between voiding and during the attempt to contract the anal sphincter in the disturbed group, but not in the normal group. It is supposed that the pressure decreased during voiding is an indication of not only normally functioning external urethral sphincter but also non-underactive detrusor, and that the pressure increase means either underactive detrusor or spastic external urethral sphincter due to detrusor-sphincter dyssynergia. To measure the urethral pressure changes at the external sphincter zone during voiding is thought to be useful for assessment of the urethral resistance at that zone.
PMID: 6084356 [PubMed – indexed for MEDLINE]
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Last Updated: July 27, 2020 by uabadmin
Investigation of postprostatectomy problems.
Investigation of postprostatectomy problems.: “
Investigation of postprostatectomy problems.
Urology. 1980 Feb;15(2):209-12
Authors: Abrams PH
Sixty patients presented with postprostatectomy problems. The symptoms of slow stream and hesitancy were associated with the urodynamic finding of an underactive detrusor more often than with persistent obstruction. The symptoms of persistent urgency, frequency, and urge incontinence were associated with bladder hypersensitivity and bladder instability. Stress incontinence was associated with low sphincter pressures demonstrated by urethral profilometry. Urodynamic studies enabled accurate diagnosis of these problems and indicated which patients had persistent obstruction (17 per cent) and would therefore benefit from additional outflow tract surgery.
PMID: 7355551 [PubMed – indexed for MEDLINE]
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Last Updated: July 27, 2020 by uabadmin
Is a Neurogenic Bladder Genetic?
Neurogenic bladder is a condition characterized by lack of bladder control related to nerve damage. While the condition is not genetic, the birth defect spina bifida may trigger it in some individuals.
The Facts
The Cleveland Clinic describes neurogenic bladder as a potential complication of any disease or physical trauma that impacts the nerves controlling bladder function. Depending on the individual, neurogenic damage can trigger either overactive or underactive bladder function.
Spina Bifida
Children’s Hospital Boston cites spina bifida as a common underlying cause of neurogenic bladder in children. This occurs when spinal changes caused by the birth defect disrupt the normal signal path of nerves related to bladder control.
Additional Causes
Children’s Hospital Boston and the Medline Plus identify additional underlying causes of neurogenic bladder that include spinal cord injury, Alzheimer’s disease, pelvic or central nervous system tumors, multiple sclerosis, diabetes and stroke recovery.
Diagnosis
Doctors diagnose neurogenic bladder through a combination of physical examination, medical history, urine testing and studies of bladder volume and pressure, according to Children’s Hospital Boston.
Treatments
Medline Plus notes potential treatments for neurogenic bladder that include medications for overactive or underactive bladder, antibiotics to address infections and exercises to strengthen pelvic floor muscles.
source: ehow
Last Updated: July 27, 2020 by uabadmin
Pyridostigmine in autonomic failure: can we treat postural hypotension and bladder dysfunction with one drug?
Pyridostigmine in autonomic failure: can we treat postural hypotension and bladder dysfunction with one drug?: “
Pyridostigmine in autonomic failure: can we treat postural hypotension and bladder dysfunction with one drug?
Clin Auton Res. 2006 Aug;16(4):296-8
Authors: Yamamoto T, Sakakibara R, Yamanaka Y, Uchiyama T, Asahina M, Liu Z, Ito T, Koyama Y, Awa Y, Yamamoto K, Kinou M, Hattori T
In a 66-year-old man with autonomic failure, pyridostigmine (180 mg/day orally) improved both postural hypotension and underactive detrusor bladder dysfunction. Acetylcholinesterase inhibition may be useful in the management of orthostatic hypotension and bladder dysfunction in autonomic failure patients.
PMID: 16862395 [PubMed – indexed for MEDLINE]
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Last Updated: July 27, 2020 by uabadmin
Intravesical electromotive drug administration technique: preliminary results and side effects.
Intravesical electromotive drug administration technique: preliminary results and side effects.: “
Intravesical electromotive drug administration technique: preliminary results and side effects.
J Urol. 1998 Jun;159(6):1851-6
Authors: Riedl CR, Knoll M, Plas E, Pflüger H
PURPOSE: We performed intravesical electromotive drug administration (EMDA) for various bladder disorders during a 3-year period and assessed the technique, possible applications, complications and outcomes of this procedure. MATERIALS AND METHODS: Intravesical EMDA was performed with local anesthetics for transurethral surgery and in combination with dexamethasone for the treatment of noninfectious chronic cystitis (interstitial/radiation cystitis), with mitomycin C for recurrence prophylaxis of high risk superficial bladder cancer and with oxybutynin/bethanechol for the hyperreflexive/acontractile detrusor. A standardized power source and electrode catheter were used for 215 treatments in 84 patients. RESULTS: Transurethral bladder tumor resections were pain-free in 10 of 12 patients. Of the 25 patients with chronic noninfectious cystitis 15 were free of symptoms for a mean of 6.6 months, and there was a 73% increase in mean bladder capacity from 244 before to 421 cc after EMDA. Of the 16 patients with superficial bladder cancer 9 were free of recurrence for a mean of 14.1 months. In 10 of 14 patients with acontractile detrusors urodynamic examination showed detrusor contraction during EMDA of bethanechol. There were no contractions without electric current. EMDA of oxybutynin reduced detrusor hyperreflexia. A bladder ulcer was the single severe local complication and 4.6% of patients, mainly those with chronic cystitis, reported significant post-EMDA bladder/urethral pain. Minor side effects accounted for 23% of all treatments. No systemic side effects occurred. CONCLUSIONS: Intravesical EMDA is effective and innocuous. The therapeutic concept combines the advantages of increased drug administration without systemic side effects.
PMID: 9598474 [PubMed – indexed for MEDLINE]
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Last Updated: July 27, 2020 by uabadmin
Cystometric Changes in Pressure-guided Acute Distension Rat Model of the Underactive Bladder™
Volume 21, Issue 2, June 2009, Pages 136-139
Copyright © 2009 Buddhist Compassion Relief Tzu Chi Foundation Published by Elsevier B.V.
Dae K. Kima, Jonathan Kaufmanb, Zhonghong Guanc, Pradeep Tyagid, Naoki Yoshimuraa, Kim A. Killingerd, Kenneth M. Petersd and Michael B. Chancellord,
aDepartment of Urology, Eulji University, Daejeon, Korea
bLipella Pharmaceuticals, Inc., Pittsburgh, PA, USA
cDepartment of Urology, State University of New York Downstate Medical School, New York, NY, USA
dDepartment of Urology, William Beaumont Hospital, Royal Oak, MI, USA
Abstract
Objective
Acute bladder distension results in pressure ischemia, subsequent reperfusion injury, and ultimately damage to the detrusor. We hypothesize that changes in pressure may be a key factor to damage resulting from over-distension and developed a pressure-guided distension model to evaluate cystometric changes.
Materials and Methods
Three groups of adult female Sprague Dawley rats (250 g) were used: a sham distended control group, a 3-day (3D) and 7-day (7D) follow-up group after pressure-guided distension. Under pentobarbital anesthesia, the urethra was clamped and saline was infused (0.04 mL/min) under continuous intravesical pressure monitoring. After reaching 120 cmH2O pressure, infusion was stopped and clamping was maintained for 30 minutes. For sham distension, all procedures except the saline infusion were done.
Results
There were no bladder ruptures during distension. Distension volumes needed to achieve the fixed pressure were variable (1.68–2.90 mL), but mean distension volumes were similar between the 3D and 7D groups (2.1 ± 0.1 mL vs. 2.2 ± 0.3 mL). After distension, maximal cystometric capacity and residual urine volume were increased at both time points. Voiding efficiencies were decreased significantly in both the 3D and 7D groups (p <>
Conclusion
Our pressure-guided distension model exhibits cystometric characteristics of bladder decompensation. This model for the underactive bladder™ (UAB) may prove useful to further the development of targeted UAB™ treatments.
Keywords: Bladder; Muscle; Retention; Underactive bladder
Last Updated: July 27, 2020 by uabadmin
Delayed traumatic thoracic spinal epidural hematoma: a case report and literature review.
Delayed traumatic thoracic spinal epidural hematoma: a case report and literature review.
Am J Emerg Med. 2007 Jan;25(1):69-71
Authors: Hsieh CT, Chiang YH, Tang CT, Sun JM, Ju DT
Spinal epidural hematoma is a relatively uncommon disease, but an important cause leading to cord compression. Posttraumatic spinal epidural hematoma is a rare entity and remains a challenge for clinical physicians. Magnetic resonance imaging is the best choice for early diagnosis, and urgent surgical decompression with evacuation of hematoma could improve some neurologic deficits, especially vital cord functions. We presented a 77-year-old woman who sustained back pain after a fall 1 month before admission, complaining of progressive weakness and sensory loss in bilateral lower extremities since 2 weeks before admission. Radiography of the thoracic spine revealed decreased body height at T10 and compression fracture. Magnetic resonance imaging of the thoracic spine revealed epidural hematomas at the level of T11 to T12. An urgent decompressive laminectomy with evacuation of hematoma was performed immediately. Postoperatively, her previous neurologic deficits improved except for an underactive neurogenic bladder and fecal incontinence.
PMID: 17157687 [PubMed – indexed for MEDLINE]
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