scholarly journals Role of Phosphodiesterase Inhibitors in Improving Urodynamic Parameters in Patients with Spinal Cord Injury: A Preliminary Report

2020 ◽  
Vol 09 (01) ◽  
pp. 30-34
Author(s):  
Muzzain Iqbal ◽  
Sarbjit Singh Chhiber ◽  
Baldev Singh Wazir ◽  
Altaf Umar Ramzan ◽  
Mohammad Saleem Wani
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Oral Dose ◽  
Single Oral Dose ◽  
Bladder Capacity ◽  
Final Conclusion ◽  
Bladder Compliance ◽  
Cord Injury ◽  
Urodynamic Parameters

Abstract Objective To analyze role of phosphodiesterase 5 (PDE5) inhibitors on urodynamic parameters in patients with suprasacral spinal cord injury. Materials and Methods This was a prospective observational hospital-based study conducted on a cohort of patients, aged between 18 and 65 years with suprasacral spinal cord injury, who were registered in Department of Neurosurgery/Urology. Cutoff period since injury was 2 years. After taking consent, baseline urodynamic study was performed, which was repeated 2 hours after taking single oral dose of 20 mg tadalafil. Urodynamic parameters such as maximum detrusor filling/voiding pressures, maximum bladder capacity, and bladder compliance before and after taking drug were compared for final results and conclusion. Results Following administration of 20 mg of tadalafil, maximum bladder capacity in mL showed statistically significant improvement from 268.39 ± 130.0 to 298.55 ± 112.0.(p < 0.05). Bladder compliance improved from 18.68 ± 6.4 to 20.25 ± 7.5 mL/cm H2O (p > 0.05). Maximum detrusor filling pressure improved from 36.03 ± 20.54 to 32.90 ± 16.47 cm H2O (p > 0.05). Maximum detrusor voiding pressure improved from 64.65 ± 33.19 to 58.13 ± 20.7 cm H2O (0 > 0.05). In patients with injury above D6 spinal cord level, statistically significant improvement was seen in maximum bladder capacity and bladder compliance after 2 hours of single oral dose of tadalafil (p < 0.05). Conclusion Our study suggests a positive role of PDE inhibitors in improving urodynamic parameters in patients with suprasacral spinal cord injury with improvement in parameters such as bladder capacity, detrusor pressures, and bladder compliance. Because this is a small study group, more studies such as this are required to reach to final conclusion.

scholarly journals Role of 10000-Fold Effect in Improving Urodynamic Parameters with Supra Spinal Cord Injury

2020 ◽  
Vol 3 (11) ◽  
pp. 26-33
Author(s):  
Vinod Kumar Tewari ◽  
Devesh Johari ◽  
Lori Tewari ◽  
Neeraj ,
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cord Injury ◽  
Urodynamic Parameters

scholarly journals THE EFFECT OF OXYBUTYNIN ON NEUROGENIC DETRUSOR OVERACTIVITY IN SPINAL CORD INJURY PATIENT: A HOSPITAL BASED INTERVENTIONAL STUDY

2021 ◽  
pp. 42-44
Author(s):  
Vineet Bharti ◽  
Nikhil Agarwal ◽  
Mrinal Joshi
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Neurogenic Bladder ◽  
Detrusor Overactivity ◽  
Anticholinergic Drug ◽  
Bladder Capacity ◽  
Spinal Cord Injury Patient ◽  
Detrusor Sphincter Dyssynergia ◽  
Bladder Compliance ◽  
Cord Injury

Neurogenic bladder dysfunction is one of prominent impairments following Spinal Cord Injury (SCI) and is seen in 90% of patients.This study has been undertaken to correlate the effect of anticholinergic drug (oxybutynin) on urodynamic parameters in neurogenic bladder of SCI patients.This is a hospital based non randomized prospective interventional study.After initial baseline urodynamic study,patients with detrusor areflexia were excluded from the study group and thirty patients showing detrusor overactivity and detrusor sphincter dyssynergia were treated with oral oxybutynin 5 mg for 7 days followed by repeat urodynamic evaluation thereafter.Our study concluded that mean bladder compliance improved from 6.114 to 17.95 ml/cmH2O after intervention and mean bladder capacity also increased after intervention (229.7ml) from (165.3ml) and changes were statistically significant.Antimuscarinic (Oxybutynin) is an effective drug in management of neurogenic bladder in SCI patients increases bladder compliance and capacity and results are objectively achieved within seven days

scholarly journals Video-Urodynamic Characteristics and Predictors of Switching from Botulinum Neurotoxin a Injection to Augmentation Enterocystoplasty in Spinal Cord Injury Patients

Toxins ◽  
2022 ◽  
Vol 14 (1) ◽  
pp. 47
Author(s):  
Chih-Chieh Lin ◽  
Hann-Chorng Kuo
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Botulinum Neurotoxin ◽  
Great Majority ◽  
Bladder Capacity ◽  
Detrusor Pressure ◽  
Cord Injury ◽  
Augmentation Enterocystoplasty ◽  
Before And After ◽  
Urodynamic Parameters

Botulinum neurotoxin type A (BoNT-A) injection and augmentation enterocystoplasty (AE) are alternative and effective management strategies for neurogenic detrusor overactivity (NDO) refractory to pharmacotherapy. A great majority of patients with spinal cord injury (SCI) may, however, prefer BoNT-A injections to AE, due to the less invasive characteristics. In this study we evaluated the influence of various video-urodynamic study (VUDS) parameters in SCI patients who continuously received repeat BoNT-A detrusor injections or switched to AE to improve their bladder conditions. We compared the changes in the urodynamic parameters before and after each mode of treatment. In this retrospective study, all SCI patients with refractory NDO who had received at least one BoNT-A injection were enrolled. VUDS was performed before and after both BoNT-A injection and AE. All of the urodynamic parameters of the storage and micturition—including the bladder capacity of every sensation, maximal flow rate (Qmax), post-voiding residual volume, detrusor pressure at Qmax, and bladder contractility index—were recorded. A total of 126 patients, including 46 women and 80 men, with a mean age of 41.8 ± 13.1 years, were recruited for this study. All of the patients receiving either BoNT-A injection or AE had a statistically significant increase of bladder capacity at every time-point during filling and a decrease in detrusor pressure at Qmax during voiding. Patients who switched from BoNT-A to AE had greater improvements in their urodynamic parameters when compared with those who continued with BoNT-A injections. Accordingly, SCI patients receiving BoNT-A injections but experiencing few improvements in their urodynamic parameters should consider switching to AE to achieve a better storage function and bladder capacity.

scholarly journals Role of melatonin in the dynamics of acute spinal cord injury in rats

2021 ◽  
Author(s):  
Jiaqi Bi ◽  
Jianxiong Shen ◽  
Chong Chen ◽  
Zheng Li ◽  
Haining Tan ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Acute Spinal Cord Injury ◽  
Cord Injury

scholarly journals Exoskeletons, Rehabilitation and Bodily Capacities

2021 ◽  
pp. 1357034X2110256
Author(s):  
Denisa Butnaru
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Crucial Role ◽  
Spinal Cord Injuries ◽  
Main Task ◽  
Cerebrovascular Accidents ◽  
Complex Processes ◽  
Cord Injury ◽  
Neurological Conditions

Motility impairments resulting from spinal cord injuries and cerebrovascular accidents are increasingly prevalent in society, leading to the growing development of rehabilitative robotic technologies, among them exoskeletons. This article outlines how bodies with neurological conditions such as spinal cord injury and stroke engage in processes of re-appropriation while using exoskeletons and some of the challenges they face. The main task of exoskeletons in rehabilitative environments is either to rehabilitate or ameliorate anatomic functions of impaired bodies. In these complex processes, they also play a crucial role in recasting specific corporeal phenomenologies. For the accomplishment of these forms of corporeal re-appropriation, the role of experts is crucial. This article explores how categories such as bodily resistance, techno-inter-corporeal co-production of bodies and machines, as well as body work mark the landscape of these contemporary forms of impaired corporeality. While defending corporeal extension rather than incorporation, I argue against the figure of the ‘cyborg’ and posit the idea of ‘residual subjectivity’.

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