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[Neurogenic bladder in HAM (HTLV-I associated myelopathy)].

Bladder dysfunction is one of the major symptomatologies characteristic to HAM (HTLV-I associated myelopathy). Four patients, 3 females and 1 male, were diagnosed by neurologists to have HAM with spastic gait disturbance and increased titer of antibody to HTLV-I. They complained of urge incontinence, bed wetting, difficulty in micturition and/or pollakisuria. Urodynamically, in 3 of them severe uninhibited detrusor contractions were observed. On the other hand, in one case detrusor contractility was lost completely at voiding. In all patients, bladder sensation was well preserved. Corticosteroids and interferon could not improve their urological symptoms. Clean intermittent catheterization (CIC) put on 3 patients who had a significant amount of residue relieved them of urinary incontinence. We believe that HAM in patients suffering from severe difficulty in micturition is a good indication for CIC.

Adult↗

[Neurophysiopathology of spinal lesions, evaluation of the 80s. Post-injury assessment and treatment of the neurogenic bladder in the acute period].

This introductory presentation deals with the recent pathophysiological aspects of the post-traumatic spinal cord lesion and the population concerned. The neurophysiology of the bladder and its sphincters is summarized so as to try and explain some disturbances occurring during the acute phase following a spinal cord injury; their clinical and urological aspects and the methods of bladder drainage.

Acute Disease↗

[Neurogenic bladder after operation of rectal cancer].

Of the patients who had had a urodynamic examination during the five year period from 1982 to 1987 in our clinic, 48 patients underwent operations for rectal cancer prior to the study. In 35 of them, the operation mode was known. If the pelvic nerve is damaged by operative modes for rectal cancer, urinary disturbances of severe kinds may occur. In spite of such disturbances, 71.4% of those who had had excision of the low anterior part and 51.9% of those with Miles' operation could be weaned from the clean intermittent self-catheterization and take up spontaneous urination. Even in patients who developed severe dysuria, if catheterized at an early stage, many of them could urinate by abdominal pressure with in several months after operation, without the aid of a catheter. This transition took place mostly within one year after operation. When a patient develops dysuria after radical surgery for rectum cancer, treatment mainly with self-catheterization is an effective method at present.

Adult↗

[[The effect of cisapride on the neurogenic bladder].

Cisapride (Prepulsid) is a new prokinetic drug of the gastrointestinal tract. It has indirect muscarinic parasympathicomimetic effects on the neuromuscular junction of smooth muscle that we also observed on the vesical function by four of the six patients presented in this study.

Adult↗