Neurogenic detrusor overactivity leak-point pressure (NDO-LPP), urodynamic findings and vesico-ureteral reflux in patients with spinal cord injury (SCI)

2017 ◽  
Vol 16 (3) ◽  
pp. e1971-e1972
Author(s):  
L. Topazio ◽  
I. Amato ◽  
V. Iacovelli ◽  
R. Miano ◽  
A. D’Amico ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Detrusor Overactivity ◽  
Neurogenic Detrusor Overactivity ◽  
Leak Point Pressure ◽  
Cord Injury ◽  
Point Pressure ◽  
Vesico Ureteral Reflux

scholarly journals 200 U vs. 300 U Botulinum Toxin a Injections for Patients with Neurogenic Detrusor Overactivity Secondary to Spinal Cord Injury

2020 ◽  
Vol 3 (1) ◽  
pp. 1-4
Author(s):  
Lin JM ◽  
◽  
Hui Chen ◽  
Liu QL ◽  
Huang MP ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Urinary Incontinence ◽  
Botulinum Toxin ◽  
Detrusor Overactivity ◽  
Botulinum Toxin A ◽  
Control Group ◽  
Neurogenic Detrusor Overactivity ◽  
Toxin A ◽  
Cord Injury

Objective: To evaluate the d the safety and efficacy of 200 U vs. 300 U botulinum toxin A (BTX-A) injections for patients with neurogenic detrusor overactivity (NDO) secondary to spinal cord injury (SCI). Methods: We retrieved the data for the patients who receive a single dose into the detrusor of BTX-A (300 U or 200 U). The clinical outcome included maximum detrusor pressure (Pdetmax) during cystometry, voiding volume, urinary incontinence (UI) episodes between CICs per 24 hour, and complete dryness. Related adverse events were recorded. Results: From July 2015 to June 2017, 28 cases received 300 U BTX-A injections (experiment group) while 19 cases received 200U BTX-A injections (control group). There were no significant differences in baseline evaluation items (gender, age, duration of spinal cord injury, level of neurological injury, AIS scores) between the two groups. There were significant improvement in Pdetmax, UI and I-QoL from baseline in the two groups. Patients in experiment group had statistically greater improvement than those in the control group for Pdetmax (-32.09 cm H2O vs. -28.02 cm H2O, P = 0.016), mean urinary incontinence episodes (-6.18/d vs. -5.01/d, P = 0.042), complete dryness (11 vs. 2, P = 0.031), mean voiding volume (160.52 ml vs. 133.66 ml, P <0.001), and I-QoL (28.53 vs. 20.41, P <0.001). Conclusion: Preliminary results indicate that 300 U BTX-A is more effective than 200 U BTX-A for SCI patients with NDO.

Urodynamic findings and urologic management of central cord syndrome

2019 ◽  
Vol 13 (4) ◽  
pp. 283-287 ◽  
Author(s):  
Athina Pirpiris ◽  
Nathan Hoag ◽  
Richard Clements ◽  
Johan Gani
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Detrusor Overactivity ◽  
Neurogenic Detrusor Overactivity ◽  
Urodynamic Studies ◽  
Urodynamic Assessment ◽  
Cord Injury ◽  
Patient Reported ◽  
Central Cord Syndrome ◽  
Injury Classification

Purpose: Central cord syndrome is the most common incomplete spinal cord injury, although urodynamic data on this subset of patients is lacking. We aim to determine the typical urodynamic features associated with this condition. Methods Consecutive patients undergoing urodynamic studies in a tertiary spinal cord unit between 2014 and 2018 were retrospectively reviewed to identify those with central cord syndrome. Charts were evaluated for demographics, spinal cord injury classification, symptoms, urodynamic parameters and treatment. Data were analysed using descriptive statistics. Results: A total of 131 consecutive patients undergoing urodynamic studies were reviewed and 33 were identified with central cord syndrome. Mean age was 46 years and 91% were male. The predominant spinal cord injury classification was American Spinal Injury Association D (52%). Overall, 94% (31/33) reported volitional voiding and normal bladder sensation. Video-urodynamics demonstrated neurogenic detrusor overactivity in 70% (23/33) of patients, with 15% (5/33) demonstrating leakage with neurogenic detrusor overactivity and 21% (7/33) having reflex emptying. In total, 94% (31/33) of patients had normal compliance, 42% (14/33) of patients had detrusor sphincter or bladder neck dyssynergia and 60% (20/33) had an alteration to their management plan following urodynamic study. Conclusion: There is discordance between subjective patient-reported symptoms and objective urodynamic findings. About two-fifths of patients may have a potentially unsafe urodynamic bladder profile and urodynamics studies resulted in a change in bladder management in the majority of patients. Urodynamic assessment of patients with central cord syndrome is essential to determine which patients require further intervention. Level of evidence: Not applicable for this multicentre audit.

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