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At least 145 records · Page 8Linked to original sources
PubMed1984

Periurethral polytetrafluoroethylene injections in incontinent female subjects with neurogenic bladder disease.

Urinary incontinence in female subjects with bladder instability secondary to neurogenic bladder disease is difficult to manage. Many times pharmacologic manipulation and the standard anti-incontinence surgical procedures are unsuccessful. We have found that the urethral occlusive technique using polytetrafluoroethylene (Teflon) paste is highly effective in maintaining continence. We describe 6 patients who achieved complete urinary control and empty the bladder with the use of intermittent catheterization. All of the patients are extremely satisfied with the end results of urinary continence and have accepted self-catheterization well.

Adult↗
PubMed1990

Efficient treatment of neurogenic bladder disorders in multiple sclerosis with initial intermittent catheterization and ultrasound-controlled training.

Out of 350 multiple sclerosis (MS) patients, 197 had residual urine (RU), on average 113 ml on admission. Treatment with initial intermittent catheterisation and bladder training normalized the neurogenic bladder disorders (NBD) in most patients; the RU was 28 ml on average at discharge. Continence improved with the reduction of RU. Even in those 37 patients with a RU of over 200 ml on admission, this management reduced the average RU to 83 ml on discharge. Patients with a RU of over 50 ml had bacteriuria 3 times more often than patients with a lower RU. In patients admitted with a long-term catheter, the catheter was removed; these patients had an average RU of 166 ml on admission, 23 ml on discharge. There was a highly significant correlation between high RU and the degree of cerebral atrophy. Patients with more than 50 ml RU at discharge were those with severe cerebral atrophy, tetraplegia and dementia. The different patterns of NBD were merely different states of the same NBD under different training conditions. Since NBD occurs about a 1,000 times more often than bowel incontinence with the same lesions in MS, it is not the cerebrospinal lesions per se, but the peripheral vicious circle they trigger, which leads to detrusor hyperactivity and dyssynergy. The peripheral pathogenetic mechanism is urinary retention leading to bladder overextension. Urodynamic investigations beyond the measurement of RU (by ultrasound) are not necessary for the treatment of NBD in most MS patients. The noninvasive and inexpensive therapy described here is effective.

Adult↗
PubMed1985

[Neurogenic bladder caused by spinal cord traction].

A neurogenic bladder was the presenting syndrome in three cases of spinal cord traction. Of the typical symptomatic triad: neuro-orthopedic, cutaneous and urologic, the latter was of primary importance. Symptoms in the first case were incomplete bladder retention with distention of upper urinary tract, right-sided vesicorenal reflux and renal insufficiency. Six months after excision of a sacral lipoma and freeing of the filum terminale, micturition had become normal without residue, and renal function normalized. Right-sided reflux was corrected by submucosal advancement surgery with good results. The clinical history was more suggestive in the second case. Although inaugural symptoms were mictional, there was foot paralysis and a retrosacral lipoma above an abnormal hairy tuft in the upper part of the gluteal cleft. Operation revealed the presence of a dermoid cyst and a lipoma. Their excision combined with section of the filum terminale allowing ascension of the medullary cone. Marked clinical and urodynamic improvement was obtained with normal micturition and disappearance of incontinence. An anti-reflux operation suppressed residual reflux with good urographic results. Marked improvement in mictional disorders was obtained also in the 3rd case after excision of a sacral extradural lipoma and section of the filum terminale, allowing objective ascension of the medullary cone by 4 cm. A very detailed analysis was conducted of similar cases reported in the literature, about 2% of neurogenic bladders in children being affected. The importance of early diagnosis is emphasized as well as the essential need to establish a precise diagnosis of the lipoma of cauda equina and of medullary fixation. Early neurosurgery is justified by the high frequency of improvement in cases treated in this way.

Adolescent↗
PubMed1992

[A case of Noonan syndrome with neurogenic bladder].

We report a case of Noonan syndrome with neurogenic bladder. The patient was a 33-year-old man with a chief complaint of difficulty in urination, urinary frequency, and incontinence of urine. He had also various malformations, as deformities of the face, skull and hard palate, webbed neck, nail abnormality, edema of the lower extremities, contraction of visual field, deafness, malrotation of the intestine and so on. The case was diagnosed as Noonan syndrome because his karyotype of chromosome was 46, XY. Malformations of the urogenital organs were mild malrotation of bilateral kidneys, a right renal cyst, left cryptorchidism and pseudo phimosis. The uroflowmetrogram of the case showed a saw-like and flat pattern, with urination starting by tapping lower abdomen by himself. The cystometry and electromyogram of the external sphincter revealed neurogenic bladder with uninhibited contraction and detrusor-external sphincter dyssynergia. This is the first case of Noonan syndrome with neurogenic bladder.

Adult↗
PubMed1978

The significance of bladder capacity under aspect of continence and micturition in neurogenic bladder dysfunction.

The bladder capacity of patients with a neurogenic bladder disorder was determined. Since the bladder capacity varies according to the type of neurogenic lesion (supranuclear, infranuclear), it was to be determined, whether reflex detrusor activity and duration of the lesion would influence bladder capacity. It was found that in supranuclear lesions s sufficient bladder capacity can be maintained with a balanced micturition, and that spincterotomy does not result in reduced bladder capacity. In infranuclear lesions intermittent catheterization is a good therapeutic method to preserve continence and an intact renal function as well.

Humans↗
PubMed1978

Ureteroneocystostomy in the treatment of reflux in neurogenic bladders.

There were 15 patients with neurogenic bladders, representing 23 renal units with reflux, who underwent reimplantation with the Politano-Leadbetter technique. The over-all success rate was 30 per cent. Failures, including persistent reflux or obstruction, were demonstrated on at least 1 side of all bilateral reimplantations and 3 of 7 unilateral procedures. These results are compared to those in the recent literature. We conclude that case selection, limiting the operation to only those patients with balanced bladders, will ensure uniformly good results. External sphincterotomy in patients with reflux may alter the clinical course, either obviating the need for reimplantation or creating a balanced bladder. Other forms of therapy, such as urinary diversion, are indicated only in those patients who persist with markedly abnormal bladders and renal deterioration.

Adolescent↗
PubMed1977

Sacral dysgenesis associated with occult spinal dysraphism causing neurogenic bladder dysfunction.

A case of a neurogenic bladder in a 20-year-old man is described. The patient had difficulty in voiding and incontinence, with a history of several urinary infections. Misdiagnoses included stricture and posterior urethral valves. Early treatment included urethral dilation, a transurethral resection and a left ureteral implantation. Throughout this time the neurological examinations were essentially normal. Final diagnosis was sacral dysgenesis with associated occult spinal dysraphism, after the discovery of a small pock mark over the sacrum and an abnormal pelvic x-ray. Urinary diversion was done.

Adult↗
PubMed1975

The silent neurogenic bladder.

Children with occult or silent neurogenic bladders may present with urinary reflux and severe upper urinary tract deterioration. Commonly, the neuro-deficit eludes detection. Reimplantation of these ureteral units will likely result in failure.

Child↗
PubMed1981

[Mitigated neurogenic bladder (author's transl)].

The mitigated neurogenic bladder is gaining increasing significance in the investigation of children suffering from recurrent therapy-resistant infection of the urinary tract or enuresis. It is found in 33 to 48% of these cases and refers to isolated functional disorders of the bladder, which do not correspond to any neurological pattern. Morphological changes, if found, only occur as a result of functional changes. The functional correlations, diagnosis and therapy are discussed together with the description of 3 cases.

Adolescent↗