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At least 73 records · Page 4Linked to original sources
PubMed1988

Bladder-outlet reconstruction in neurogenic bladder due to myelomeningocele.

In a subgroup of children with myelomeningocele, urinary incontinence cannot be managed by clean intermittent catheterization and anticholinergic medication. The authors report on 24 such children who required bladder-outlet reconstruction. Twelve boys underwent the Young-Dees/Leadbetter procedure, 8 girls underwent the Burch procedure and the remaining 4 had a combination of the two. Augmentation cystoplasty was also carried out in seven girls and one boy. Results were most favourable in the girls, with improvement in 92%, in contrast to the boys in whom only 58% were improved. Artificial sphincter placement may be a more beneficial alternative for boys.

Adolescent↗
PubMed1988

[Transurethral resection of bladder neck in female patients with neurogenic bladder].

Transurethral resection of the bladder neck was performed in 6 female patients with neurogenic bladders who presented with a large volume of residual urine and bladder neck obstruction on voiding cystourethrography without detrusor hyperreflexia on cystometry. In 4 of the patients, transurethral sphincterotomy was performed concomitantly. Five of the patients demonstrated significant improvement in bladder emptying and 4 did not need self-catheterization. No complications of the operation were observed.

Adult↗
PubMed1990

Management of the obstructed urinary tract associated with neurogenic bladder dysfunction.

The child with neurogenic bladder dysfunction may suffer from lower urinary tract obstruction, which, if untreated, can result in upper urinary tract deterioration. It is prudent to identify those newborns and infants who are at risk for upper urinary tract deterioration and advise an appropriate treatment protocol. In order to identify those children at risk, a thorough examination is required, along with appropriate upper urinary tract imaging studies and urodynamic assessment of the bladder. Infants and children at risk for upper tract deterioration are those who have intermittent or continuous detrusor pressure elevation above 40 cm H2O. We have identified the safe period, which is the time during which the bladder remains at a pressure lower than 40 cm H2O. Our management protocol for each child is individualized and based on increasing the safe period. The safe period can be increased with a combination of intermittent catheterization, administration of medications, and, in some cases, surgical reconstruction. With compulsive evaluation and intensive management, many of the previous upper urinary tract changes associated with the obstructed neurogenic bladder can be averted. With the above factors in mind, we have defined the period of bladder filling and storage where the pressure is below 40 cm H2O as the safe period. The ideal bladder for maintenance of normal upper tracts would have a long safe period and low voiding pressure. Our treatment protocol for the neurogenic bladder is therefore dependent on identifying those children who have very short or nonexistent safe periods. These are the children who are at risk for upper tract deterioration.

Child↗
PubMed1991

[Pharmacologic characteristics of human neurogenic bladder: response to KCl, carbachol, ATP and CaCl2].

Pharmacologic characteristics of the human neurogenic bladder to KCl, carbachol, ATP and CaCl2 was investigated in vitro in comparison with the control bladder. Patients with neurogenic bladder underwent augmentation enterocystoplasty because of low bladder compliance or uninhibited contraction which resulted in urinary incontinence and/or vesicoureteral reflux. 1. There was no difference in the contractile strength to KCl between the neurogenic bladder and the control. 2. The contractility (both contractile strength and the value of ED50) to carbachol was than in the control. 3. The contractile strength of the neurogenic bladder to ATP showed greater efficacy than that of the control bladder. 4. The contractility of the neurogenic bladder (contractile strength and the value of ED50) to CaCl2 was significantly greater than that of the control. 5. In the neurogenic bladder there was no correlation between pharmacological responsiveness and the clinical parameters including the data of cystometry. In conclusion, the human neurogenic bladder demonstrated supersensitive responses to carbachol, ATP and CaCl2.

Adenosine Triphosphate↗
PubMed1980

Clean intermittent self-catheterization in the chronical management of the neurogenic bladder.

30 patients with neurogenic bladder dysfunction were treated with intermittent self-catheterization. Since the application of this method, urine loss has disappeared almost completely and the urinary infection rate has decreased. In some cases there was radiological improvement of the upper urinary tract. In all the other patients no kidney deterioration was found on intravenous pyelography. In most cases the method brought a real improvement in social life.

Adult↗