scholarly journals Satisfaction with Detrusor OnabotulinumtoxinA Injections and Conversion to Other Bladder Management in Patients with Chronic Spinal Cord Injury

Toxins ◽  
2022 ◽  
Vol 14 (1) ◽  
pp. 35
Author(s):  
Sheng-Fu Chen ◽  
Yuan-Hong Jiang ◽  
Jia-Fong Jhang ◽  
Hann-Chorng Kuo
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Urinary Incontinence ◽  
Surgical Procedures ◽  
Current Status ◽  
Chronic Spinal Cord Injury ◽  
Management Procedures ◽  
Urological Complications ◽  
Cord Injury ◽  
Bladder Management

This study investigated the satisfaction with continued detrusor Botox injections for urinary incontinence and conversion to other surgical procedures and bladder management procedures for neurogenic detrusor overactivity (NDO) in patients with chronic spinal cord injury (SCI). A total of 223 patients with chronic SCI underwent detrusor Botox 200U for urodynamically confirmed NDO and urinary incontinence. After initial detrusor Botox injections, patients opted to either continue detrusor Botox injections every six to nine months and on clean intermittent catheterization (CIC), switch to other bladder management procedures, or receive surgical procedures to improve their urinary incontinence, correct emergent complications, or have better voiding conditions without CIC. Urinary incontinence improvement rates and satisfaction with bladder management were assessed and compared between different subgroups, urodynamic parameters, and bladder management procedures. Finally, a total of 154 male and 69 female patients were included, among whom 56 (25.1%), 81 (36.3%), 51 (22.9%), and 35 (15.7%) showed a marked, moderate, mild, and no reduction in urinary incontinence, respectively. However, only 48.4% of the patients continued detrusor Botox injections over the mean follow-up period of seven years. Patients with cervical or thoracic SCI had fair incontinence improvement rates. The presence of high detrusor pressure and higher-grade bladder outlet resistance also predicted a decrease in incontinence. Although more than 50% of the patients switched to other bladder management procedures or received surgical treatment, 69.1% expressed satisfaction with their current status. This large cohort of patients with chronic SCI who received initial detrusor Botox injections revealed that only 48.4% continued with Botox injections. Those who received surgical procedures due to urological complications or demanded change in bladder management could achieve high satisfaction rates.

scholarly journals ACUPUNCTURE FOR URINARY INCONTINENCE IN PATIENTS WITH CHRONIC SPINAL CORD INJURY

1998 ◽  
Vol 89 (7) ◽  
pp. 665-669 ◽  
Author(s):  
Hisashi Honjo ◽  
Hiroshi Kitakoji ◽  
Kenji Kawakita ◽  
Masahito Saitoh ◽  
Osamu Ukimuta ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Urinary Incontinence ◽  
Chronic Spinal Cord Injury ◽  
Cord Injury

scholarly journals Bladder management methods and urological complications in spinal cord injury patients

2011 ◽  
Vol 45 (2) ◽  
pp. 141 ◽  
Author(s):  
Roop Singh ◽  
RajeshKumar Rohilla ◽  
Kapil Sangwan ◽  
Ramchander Siwach ◽  
NarenderKumar Magu ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Urological Complications ◽  
Cord Injury ◽  
Bladder Management

scholarly journals Long term Urological complications in patients with Spinal cord injury

2018 ◽  
Vol 17 (2) ◽  
pp. 38
Author(s):  
Bikash Bikram Thapa ◽  
Dhan Bahadur Shrestha ◽  
Naryan Thapa ◽  
Bharat Bahadur Bhandari
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Urinary Bladder ◽  
Tract Infection ◽  
Urological Complications ◽  
Cord Injury ◽  
Bladder Management ◽  
Urinary Bladder Calculi

<p><strong>Introduction: </strong>Neurogenic bladder (NGB) is common in daily urological practice; however, information on types of urological complications encountered in army and veterans are not under strict surveillance and little is known to them about the best way to manage the condition. This observational study aimed to determine the types of urological complications encountered in regular soldiers and veterans with traumatic spinal cord injury (SCI) with NGB, and the usage of bladder management programs to deal with NGB.</p><p class="Default"><strong>Methods: </strong>We retrospectively reviewed the charts and records of interviewed patients with SCI in our urology clinic. Demographic data collected included: age, gender, mode of injury and level of spinal injury. Also noted were episodes of urinary tract infection (UTI), renal lesions, and bladder program followed.</p><p class="Default"><strong>Results: </strong>The mean age of our study sample (N= 63) was 40± 10.8 years and all were male. Age at onset of injury was 33.8 ± 16.6 years and duration since SCI insult was 90.6 ± 54 months. Symptomatic urinary tract infection (75%), chronic cystitis (53.3%), hydro-nephrosis (36.5%) and urinary bladder calculi (33.3%) were the common urological lesion observed.  Indwelling Foley’s catheterization methods of urinary bladder management in 54% study population where urinary tract infection is more common (p&lt;0.05).</p><p class="Default"><strong>Conclusion: </strong>Urinary tract infection, hydro-nephrosis and Urinary bladder calculi were the most common urological complications encountered in army and veterans with NGB. Indwelling Foley’s catheter was the most frequently used bladder management program with the higher risk for UTI.</p><p><strong>Key words:</strong> Neurogenic bladder, Spinal cord injury, Urinary tract infection, Nepal, Army</p>

scholarly journals Long term Urological complications in patients with Spinal cord injury

2018 ◽  
Vol 17 (1) ◽  
pp. 38-43
Author(s):  
Bikash Bikram Thapa ◽  
Dhan Bahadur Shrestha ◽  
Naryan Thapa ◽  
Bharat Bahadur Bhandari
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Urinary Bladder ◽  
Tract Infection ◽  
Urological Complications ◽  
Cord Injury ◽  
Bladder Management ◽  
Urinary Bladder Calculi

Introduction: Neurogenic bladder (NGB) is common in daily urological practice; however, information on types of urological complications encountered in army and veterans are not under strict surveillance and little is known to them about the best way to manage the condition. This observational study aimed to determine the types of urological complications encountered in regular soldiers and veterans with traumatic spinal cord injury (SCI) with NGB, and the usage of bladder management programs to deal with NGB.Methods: We retrospectively reviewed the charts and records of interviewed patients with SCI in our urology clinic. Demographic data collected included: age, gender, mode of injury and level of spinal injury. Also noted were episodes of urinary tract infection (UTI), renal lesions, and bladder program followed.Results: The mean age of our study sample (N= 63) was 40± 10.8 years and all were male. Age at onset of injury was 33.8 ± 16.6 years and duration since SCI insult was 90.6 ± 54 months. Symptomatic urinary tract infection (75%), chronic cystitis (53.3%), hydro-nephrosis (36.5%) and urinary bladder calculi (33.3%) were the common urological lesion observed.  Indwelling Foley’s catheterization methods of urinary bladder management in 54% study population where urinary tract infection is more common (p<0.05).Conclusion: Urinary tract infection, hydro-nephrosis and Urinary bladder calculi were the most common urological complications encountered in army and veterans with NGB. Indwelling Foley’s catheter was the most frequently used bladder management program with the higher risk for UTI.

scholarly journals Real-World Data Regarding Satisfaction to Botulinum Toxin A Injection into the Urethral Sphincter and Further Bladder Management for Voiding Dysfunction among Patients with Spinal Cord Injury and Voiding Dysfunction

Toxins ◽  
2022 ◽  
Vol 14 (1) ◽  
pp. 30
Author(s):  
Cheng-Ling Lee ◽  
Jia-Fong Jhang ◽  
Yuan-Hong Jiang ◽  
Hann-Chorng Kuo
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Botulinum Toxin ◽  
Surgical Procedures ◽  
Voiding Dysfunction ◽  
Botulinum Toxin A ◽  
Urethral Sphincter ◽  
Toxin A ◽  
Cord Injury ◽  
Bladder Management

Purpose: This study aimed to investigate improvement in voiding condition after the initial botulinum toxin A (BoNT-A) injection into the urethral sphincter among patients with chronic spinal cord injury (SCI) and voiding dysfunction. Moreover, subsequent surgical procedures and bladder management were evaluated. Materials and Methods: From 2011 to 2020, 118 patients with SCI and dysuria who wanted to void spontaneously received their first BoNT-A injection at a dose of 100 U into the urethral sphincter. Improvement in voiding and bladder conditions after BoNT-A treatment were assessed. Next, patients were encouraged to continually receive BoNT-A injections into the urethral sphincter, convert to other bladder managements, or undergo surgery. After undergoing bladder management and surgical procedures, the patients were requested to report improvement in voiding condition and overall satisfaction to bladder conditions. Then, data were compared. Results: In total, 94 male and 24 female participants were included in this analysis. Among them, 51 presented with cervical, 43 with thoracic, and 24 with lumbosacral SCI. After BoNT-A injections into the urethral sphincter, 71 (60.2%) patients, including 18 (15.3%) with excellent, and 53 (44.9%) with moderate improvement, had significant improvement in voiding condition. Patients with cervical SCI (66.6%), detrusor overactivity and detrusor sphincter dyssynergia (72.0%), partial hand function (80.0%), and incomplete SCI (68.4%) had a better improvement rate than the other subgroups. Only 42 (35.6%) patients continually received treatment with BoNT-A injections into the urethral sphincter. Meanwhile, more than 60% of patients who converted their treatment to augmentation enterocystoplasty (n = 5), bladder outlet surgery (n = 25), BoNT-A injections into the detrusor muscle (n = 20), and medical treatment (n = 55) had moderate and marked improvement in voiding dysfunction and overall satisfaction. Discussion: Although BoNT-A injections into the urethral sphincter could improve voiding condition, only patients with SCI who presented with voiding dysfunction were commonly satisfied. Those whose treatments were converted to other bladder managements, which can promote urinary continence, or to surgical procedures, which can facilitate spontaneous voiding, had favorable treatment outcomes.

Pharmacological Approaches to Chronic Spinal Cord Injury

2013 ◽  
Vol 19 (24) ◽  
pp. 4423-4436 ◽  
Author(s):  
Inge Steuer ◽  
Pascal Rouleau ◽  
Pierre Guertin
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Chronic Spinal Cord Injury ◽  
Cord Injury

Stem Cell Transplantation: A Promising Therapy for Spinal Cord Injury

2020 ◽  
Vol 15 (4) ◽  
pp. 321-331 ◽  
Author(s):  
Zhe Gong ◽  
Kaishun Xia ◽  
Ankai Xu ◽  
Chao Yu ◽  
Chenggui Wang ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Stem Cells ◽  
Spinal Cord Injury ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Therapeutic Potential ◽  
Embryonic Stem ◽  
Current Status ◽  
Cord Injury

Spinal Cord Injury (SCI) causes irreversible functional loss of the affected population. The incidence of SCI keeps increasing, resulting in huge burden on the society. The pathogenesis of SCI involves neuron death and exotic reaction, which could impede neuron regeneration. In clinic, the limited regenerative capacity of endogenous cells after SCI is a major problem. Recent studies have demonstrated that a variety of stem cells such as induced Pluripotent Stem Cells (iPSCs), Embryonic Stem Cells (ESCs), Mesenchymal Stem Cells (MSCs) and Neural Progenitor Cells (NPCs) /Neural Stem Cells (NSCs) have therapeutic potential for SCI. However, the efficacy and safety of these stem cellbased therapy for SCI remain controversial. In this review, we introduce the pathogenesis of SCI, summarize the current status of the application of these stem cells in SCI repair, and discuss possible mechanisms responsible for functional recovery of SCI after stem cell transplantation. Finally, we highlight several areas for further exploitation of stem cells as a promising regenerative therapy of SCI.

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