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At least 469 records · Page 26Linked to original sources
PubMed2001

Neurogenic and non-neurogenic bladder dysfunction.

Children with a neurological defect have a clear cause for their bladder dysfunction; however, in neurologically normal children the cause of their incontinence is usually unclear. When no anatomical abnormalities seem to be present a functional problem is generally the cause. This type of incontinence is referred to as 'functional incontinence'. The different forms of bladder and sphincter dysfunction will be discussed and treatment modalities described. As the treatment modalities in children with neuropathic bladders focus on medical and especially surgical options, special attention is paid to new developments in surgical treatment. For those with functional incontinence treatment options are more variable and the new developments are described.

Child↗
PubMed2002

Conservative management in neurogenic bladder dysfunction.

PURPOSE OF REVIEW: A few decades ago, urinary diversion, usually with an ileal conduit, was the ultimate outcome for most children with spina bifida. The revolutionary institution of clean intermittent catheterization has changed the algorithm totally. Furthermore many new drugs have been developed during the past decade and have decreased the need for surgery dramatically. In this article, we will focus on the most recent data on new modalities of therapy to help avoid urinary diversion or bladder augmentation. RECENT FINDINGS: In addition to clean intermittent catheterization and oxybutynin treatment, a new generation of anticholinergic medications, such as tolterodine, has been developed. For patients who drop out because of the side-effects of oral administration, new methods of administration are now available, including extended release and intravesical instillation. For those unresponsive, botulinum-A toxin and resiniferatoxin are two relatively new drugs in the field, administered as intravesical injection and instillation, respectively. Intravesical or transdermal electrical stimulation, sacral nerve stimulation and biofeedback therapy are under development, but as currently administered, are not yet completely successful. SUMMARY: Although life-saving in many respects, bladder augmentation introduces life-long risks of its own. Our goal in describing 'conservative' management is to prevent this step. Many alternatives to surgery are available now and more effective strategies are under development.

Anti-Dyskinesia Agents↗
PubMed1997

Neurogenic bladder may be a side effect of focus resection in an epileptic patient.

A 34-year-old man with intractable epilepsy was treated by focus resection. The resected volume of neocortex in the left supracallosal part of the medial frontal gyrus was 7 x 1 x 2.5 cm. The treatment was effective and epileptic attacks completely disappeared. However, the patient developed urinary incontinence postoperatively without any other new neurological abnormalities. Urodynamic study revealed loss of bladder sensation, increased bladder capacity, involuntary detrusor contraction, and synergic external sphincter. The suprcallosal part of the medial frontal gyrus has been reported to include 1 of the suprapontine micturition centers. In this case, resection of this area significantly affected bladder function. Loss of bladder sensation and increased threshold volume on micturition are characteristic signs of deficit in this area.

Adult↗
PubMed1977

The catheter team: an essential service for rehabilitating neurogenic bladders.

A carefully controlled programme of intermittent catheterization provides substantially better care of the bladder than indwelling catheters during the initial period after acute spinal cord injury. It is very difficult to maintain a programme of intermittent catheterization around the clock without a small team of nursing personnel highly skilled in the technique of aseptic catheterization. the practical details of setting up a catheter team are described. Some of the results that have been associated with the establishment of such a team at the Rehabilitation Branch of the Royal Perth Hospital are presented.

Bacteriuria↗
PubMed1988

Management of vesico-ureteric reflux in myelodysplasia neurogenic bladder.

During the period 1978-87, 22 patients with myelodysplasia had surgery for vesico-ureteric reflux (VUR) and seven patients with VUR were managed non-operatively. Clean intermittent catheterization was an integral part of the management in both the operated and non-operated cases. The majority of patients had reflux-related upper tract changes pre-operatively, but after operation the urinary tract was stabilized in all but one kidney which was lost. Transverse advancement ureteric reimplantation or the pull-through technique provided satisfactory results, giving a total of 29 refluxing units managed surgically.

Child↗
PubMed1975

The effect of an antibacterial drug on urinary calcium, magnesium and phosphorus excretion in patients with neurogenic bladder.

The effect of the simultaneous administration of hexamine mandelate and methionine on the urinary excretion of calcium, magnesium and phosphate is reported in 3 groups of paraplegic patients. Long-term therapy with G 500 increases bone loss in paralysed patients, and is contra-indicated when there is infection of the urinary tract by urea-splitting organisms.

Adolescent↗
PubMed1979

"Undiversion" with colocystoplasty for neurogenic bladder. A report of 2 cases.

The encouraging success of partial replacement of the bladder for interstitial cystitis and for contracted bladder due to tuberculosis, and the relative success of total bladder replacement for carcinoma, prompted an attempt to reconstruct a bladder in 2 patients with neuropathic bladders, who had problems with their ileal conduit and, thus, "undivert" them. Bladder reconstruction in these patients was performed using a modified technique of colocystoplasty. One of the patients has had 2 normal pregnancies since colocystoplasty.

Adult↗
PubMed1982

Urodynamics of neurogenic bladder in children. A comparative study with clinical and radiological conclusions.

The clinical, radiological and urodynamic investigations of 83 children are presented. Neuropathic bladders were divided into 2 main categories: those without outflow obstruction (36 patients) and those with outflow obstruction (47 patients). Although clinical and radiological findings proved sufficient for the management of these patients, the urodynamic investigations led to a precise diagnosis of the type of neuropathic bladder, an understanding of the mechanism of obstruction and, during follow-up, demonstrated the appearance of obstruction before this was shown radiologically.

Adolescent↗
PubMed1985

Minor defects of the sacrum and neurogenic bladder dysfunction.

Minor defects of the sacrum are common and often dismissed as normal. The radiographs of 100 patients with urinary incontinence revealed sacral abnormalities in 43. Sacral evoked responses were measured and compared independently with the radiological findings. Patients who had defective closure of the dorsal neural arches of S1 or S2 all had abnormal nerve studies. We suggest that incomplete development of the bones of the dorsal neural arches of the upper sacrum may be a marker of incomplete neurogenesis of the sacral nerves. The sacral neurological deficit is subtle and difficult to demonstrate, but it is real and may be important in the pathogenesis of incontinence.

Adolescent↗
PubMed1992

Neurogenic bladder dysfunction in lumbar intervertebral disc prolapse.

Lumbar disc prolapse with urinary dysfunction is an uncommon condition. The clinical, pathological and follow-up details of 30 patients are presented. Detrusor recovery is rare and most patients are left with an areflexic bladder. Female patients with lumbar disc prolapse and an areflexic detrusor who strain to empty their bladders are likely to develop genuine stress incontinence. This may be managed by the early institution of intermittent self-catheterisation, which may reduce the need for incontinence surgery.

Adult↗