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 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.

37. H-reflex and F-wave of the patients of spinal cord injury before and after intrathecal baclofen injection

2010 ◽  
Vol 121 (7) ◽  
pp. e27
Author(s):  
Katsuhiro Mizuno ◽  
Kazushige Hasegawa ◽  
Osamu Uemura ◽  
Daisuke Matsuura ◽  
Masako Katahira ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Intrathecal Baclofen ◽  
H Reflex ◽  
Cord Injury ◽  
Before And After ◽  
F Wave

Leptin response to short-term fasting in sympathectomized men: role of the SNS

2003 ◽  
Vol 284 (3) ◽  
pp. E634-E640 ◽  
Author(s):  
Justin Y. Jeon ◽  
Vicki J. Harber ◽  
Robert D. Steadward
Keyword(s):  
Body Mass Index ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Nervous System ◽  
Short Term ◽  
Cord Injury ◽  
Before And After ◽  
Sympathetic Nervous ◽  
Plasma Leptin

We studied plasma leptin levels in six people with high-lesion spinal cord injury [SCI; body mass index (BMI) 25.9 ± 1.5 kg/m2, age 37 ± 3.0 yr] and six able-bodied (AB) controls (BMI 29.1 ± 1.9 kg/m2, age 35 ± 3.5 yr) before and after 12, 24, and 36 h of fasting. The plasma leptin levels significantly decreased during 36 h fasting by 48.8 ± 4.5% (pre: 11.3 ± 2.3, post: 6.2 ± 1.5 ng/ml) and 38.6 ± 7.9% (pre: 7.6 ± 5.0, post: 4.2 ± 1.0 ng/ml) in SCI and AB, respectively. Plasma leptin started to decrease at 24 h of fasting in the SCI group, whereas plasma leptin started to decrease at 12 h of fasting in the AB group. The current study demonstrated that plasma leptin decreased with fasting in both SCI and AB groups, with the leptin decrease being delayed in the SCI group. The delayed leptin response to fasting in the SCI group may be because of increased fat mass (%body fat, SCI: 33.8 ± 3.0, AB: 24.1 ± 2.9) and sympathetic nervous system dysfunction.

scholarly journals The Effects of Adding Transcutaneous Spinal Cord Stimulation (tSCS) to Sit-To-Stand Training in People with Spinal Cord Injury: A Pilot Study

2020 ◽  
Vol 9 (9) ◽  
pp. 2765
Author(s):  
Yazi Al’joboori ◽  
Sarah J. Massey ◽  
Sarah L. Knight ◽  
Nick de N. Donaldson ◽  
Lynsey D. Duffell
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Pilot Study ◽  
Outcome Measures ◽  
Spinal Cord Stimulation ◽  
International Standards ◽  
Sit To Stand ◽  
Cord Injury ◽  
Before And After

Spinal cord stimulation may enable recovery of volitional motor control in people with chronic Spinal Cord Injury (SCI). In this study we explored the effects of adding SCS, applied transcutaneously (tSCS) at vertebral levels T10/11, to a sit-to-stand training intervention in people with motor complete and incomplete SCI. Nine people with chronic SCI (six motor complete; three motor incomplete) participated in an 8-week intervention, incorporating three training sessions per week. Participants received either tSCS combined with sit-to-stand training (STIM) or sit-to-stand training alone (NON-STIM). Outcome measures were carried out before and after the intervention. Seven participants completed the intervention (STIM N = 5; NON-STIM N = 2). Post training, improvements in International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) motor scores were noted in three STIM participants (range 1.0–7.0), with no change in NON-STIM participants. Recovery of volitional lower limb muscle activity and/or movement (with tSCS off) was noted in three STIM participants. Unassisted standing was not achieved in any participant, although standing with minimal assistance was achieved in one STIM participant. This pilot study has shown that the recruitment of participants, intervention and outcome measures were all feasible in this study design. However, some modifications are recommended for a larger trial.

Effect of Antiseptic Agents on Skin Flora of the Perineum of Men with Spinal Cord Injury

1984 ◽  
Vol 5 (9) ◽  
pp. 431-434 ◽  
Author(s):  
Donna S. Gilmore ◽  
John Z. Montgomerie ◽  
Irene E. Graham ◽  
Donald G. Schick ◽  
Enes M. Jimenez
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Povidone Iodine ◽  
Aerobic Bacteria ◽  
Penile Shaft ◽  
Skin Flora ◽  
Cord Injury ◽  
Before And After ◽  
Male Patients

Abstract Male patients with spinal cord injury are frequently colonized with P. aeruginosa and K. pneumoniae on the perineum. Regular bathing with bar soap has not influenced this colonization. We have attempted to remove these bacteria using antiseptic agents. The number of P. aeruginosa, K. pneumoniae and total aerobic bacteria on the perineum and the penile shaft was determined before and after cleaning with bar soap, chlorhexidine, povidone-iodine and pHresh. Povidone-iodine and chlorhexidine had no advantage over bar soap or pHresh in the removal of P. aeruginosa or K. pneumoniae from the perineum of patients with spinal cord injury.

Unwanted Muscle Weakness following Botulinum Neurotoxin A Administration in Spinal Cord Injury with Literature Review

2012 ◽  
Vol 23 (1) ◽  
pp. 20-24
Author(s):  
Tapan N Joshi
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Adverse Effects ◽  
Muscle Weakness ◽  
Botulinum Neurotoxin ◽  
Adult Population ◽  
Functional Decline ◽  
High Dose ◽  
Botulinum Neurotoxin A ◽  
Cord Injury

Abstract Botulinum neurotoxin A (BoNTA) is rapidly gaining acceptance for management of spasticity secondary to spinal cord injury (SCI). Due to its increased usage, more undesirable effects and complications have come in light. Unwanted distant and/or generalised muscle weakness is possible following BoNTA administration in SCI population causing temporary neurological and functional decline. Physicians should carefuly perform a clinical assessment of every patient individually for risks stratification. Additional studies for adult population evaluating adverse-effects of high dose of BoNTA treatment for spasticity management are indicated.

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