<strong>Objective:</strong> To probe into the effect of catgut implantation at Baliao and Xingfu One Acupuncture Point on dysdefecation in patients with incomplete spinal cord injury (SCI). <strong>M...<strong>Objective:</strong> To probe into the effect of catgut implantation at Baliao and Xingfu One Acupuncture Point on dysdefecation in patients with incomplete spinal cord injury (SCI). <strong>Methods:</strong> Three SCI patients voluntarily accepted catgut embedding at Baliao and Xingfu One Acupuncture point. Before and after treatment, they were filled out the self-rating scale of defecation, including the data of defecation frequency, total defecation time, defecation effort, fecal texture, fecal characteristics and fecal incontinence, etc. <strong>Results:</strong> Compared with the baseline data, constipation was improved and fecal incontinence was disappeared. <strong>Conclusions:</strong> Catgut implantation at Baliao and Xingfu One Acupuncture Point is effectual for patients with neurogenic dysporia secondary to incomplete SCI.展开更多
<strong>Background: </strong>Though anticholinergic drugs are considered the standard treatment for neurogenic detrusor overactivity, it is far from an ideal tool, because of their adverse effects such as ...<strong>Background: </strong>Though anticholinergic drugs are considered the standard treatment for neurogenic detrusor overactivity, it is far from an ideal tool, because of their adverse effects such as Constipation or not respond sufficiently for a substantial proportion of patients. Recently mirabegron has become a commonly used overactive bladder medication in the general population, but few studies about mirabegron for the treatment of neurogenic detrusor overactivity. <strong>Objective:</strong> To evaluate the efficacy and safety of mirabegron for the treatment of neurogenic lower urinary tract dysfunction. <strong>Study Design:</strong> Prospective study. <strong>Methods:</strong> This prospective study included 13 adult patients with neurogenic lower urinary tract dysfunction as a result of spinal cord injury. All patients receiving mirabegron treatment (50 mg once daily) at least 6 weeks. The effective outcomes included the mean urine volume per catheterization, urinary incontinence episodes and Incontinence Specific Quality of Life Instrument. We monitored the blood pressure and heart rate to assess the cardiovascular safety, other adverse events were also recorded. <strong>Results:</strong> A total of 13 patients were included. After 6 weeks of treatment, all patients experienced a significant increase in the mean volume of per catheterization from 238.46 ± 65.43 ml to 327.69 ± 59.04 ml (p = 0.001). There is a significant reduction in the volume of urine leakage (463.85 ± 247.98 ml VS 180.00 ± 190.96 ml, p = 0.003) and incontinence episodes per 24 h (4.46 ± 2.03 VS 1.92 ± 1.50, p = 0.001). Significant improvement in mean Incontinence Specific Quality of Life Instrument was also found (p = 0.001). No patients reported dry mouth during the study, and the cardiovascular safety were acceptable. <strong>Conclusion:</strong> Mirabegron is safe and effective in the treatment of neurogenic lower urinary tract dysfunction. It might be a good choice for reducing the cessation of clean intermittent cathet展开更多
<strong>Objective:</strong> The objective is to evaluate autonomic dysreflexia (AD) severity between urodynamics and cystoscopy in patients with spinal cord injury (SCI) above thoracic 6 (T6). <strong&g...<strong>Objective:</strong> The objective is to evaluate autonomic dysreflexia (AD) severity between urodynamics and cystoscopy in patients with spinal cord injury (SCI) above thoracic 6 (T6). <strong>Design:</strong> It is a cross-sectional survey. <strong>Subject and methods: </strong>The study was carried out in 22 patients with SCI above T6 who underwent both procedures of urodynamics and cystoscopy;all patients developed episodes of AD. The systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured and recorded at the beginning and during the various stages of the two examinations. AD was defined as a rise in SBP above 20 mm Hg. <strong>Results: </strong>There was no significant difference in SBP and DBP at baseline before urodynamics and cystoscopy. Both urodynamics and cystoscopy triggered episodes of AD. The volume of water instilled during cystoscopy was typically standard and smaller (150 mL) in comparison with urodynamics, where volume varied depending on cystometric bladder capacity (the mean bladder volume in our study was 234.86 ± 139.06 mL). The SBP was significantly different between cystoscopy and urodynamics (49.23 ± 23.07 mm Hg and 35.14 ± 15.75 mm Hg, respectively;P = 0.023). <strong>Conclusions: </strong>Although bladder distension during cystoscopy was less than that in urodynamics, the severity of AD was more pronounced during cystoscopy. It is recommended that monitoring of cardiovascular parameters during these procedures should be routinely performed.展开更多
<strong>Objective:</strong> To evaluate the efficacy and safety of Combined detrusor and external urethral sphincter BTX-A injections for detrusor overactivity (DO) and detrusor external sphincter dyssyner...<strong>Objective:</strong> To evaluate the efficacy and safety of Combined detrusor and external urethral sphincter BTX-A injections for detrusor overactivity (DO) and detrusor external sphincter dyssynergia (DESD) secondary to spinal cord injury. <strong>Study Design:</strong> Prospective study. <strong>Methods:</strong> The study was carried out in 18 SCI patients with detrusor overactivity (DO) and detrusor external sphincter dyssynergia (DESD) receiving Combined detrusor and external urethral sphincter BTX-A injections treatment. Contain 200 U botulinum toxin intradetrusor and 100 U external urethral sphincter injections. The effective outcomes included maximum detrusor pressure at first DO and DESD (PdetmaxDO-DESD), volume at first DO and DESD (VDO-DESD), maximum urethral closure pressure (MUCP), and Incontinence-Specific Quality-of-Life Instrument (I-QoL). Adverse events were recorded. <strong>Results:</strong> All patients experienced a significant mean reduction in PdetmaxDO-DESD (50.75%), maximum urethral closure pressure (26.34%) and a significant mean increase in VDO-DESD (63.00%) 12-weeks post-injection. Significant (p < 0.001) improvement in mean Incontinence-Specific Quality-of-Life Instrument was also found. No obvious adverse event and toxic effect was observed. <strong>Conclusion:</strong> Combined detrusor and external urethral sphincter BTX-A injections is a good choice for patients with DO and DESD secondary to spinal cord injury. It could not only protect the upper urinary tract but also improve quality of life.展开更多
<strong>Objective:</strong> Explore the rule of autonomic nervous dysfunction in the patients with urination disorder after high level spinal cord injury, and seek a safe, objective and accurate method to ...<strong>Objective:</strong> Explore the rule of autonomic nervous dysfunction in the patients with urination disorder after high level spinal cord injury, and seek a safe, objective and accurate method to evaluate autonomic nervous function. <strong>Patients and Method:</strong> 48 patients with dysuria after cervicothoracic SCI were selected. Before, during and after imaging urodynamic examination with slow filling in supine position, blood pressure and ECG were monitored simultaneously. The symptoms of sweating, shivering, headache, flushing and chills were observed and recorded. The study of the relationship among the changes of blood pressure, heart rate and urodynamic indexes and the above symptoms was analyzed. <strong>Results:</strong> They were divided into three groups: group A (no obvious abnormality), group B (hyperactivity) and group C (hypoactivity) according to their BP, HR and existing the symptoms or not. <strong>Conclusion:</strong> The incidence of autonomic dysfunction in the high level SCI patients with dysuria was very high (79.17%), most of them were hyperactivity, and a few were low function. The changes of SBP and DBP in the hypoactivity group all appeared an increasing and then declining trend, while the change of HR in the low function one was lower than normal and decreased continuously. The main inducements of AD are neurogenic detrusor overactivity, detrusor sphincter dyssynergia, elevated abdominal pressure and abnormal bladder sensitivity. The asymptomatic patients had a higher occurrence rate (43.75%). Only by imaging urodynamic examination with slow filling and synchronous blood pressure monitoring, can autonomic nervous function of the patients be evaluated safely, objectively, early and accurately.展开更多
文摘<strong>Objective:</strong> To probe into the effect of catgut implantation at Baliao and Xingfu One Acupuncture Point on dysdefecation in patients with incomplete spinal cord injury (SCI). <strong>Methods:</strong> Three SCI patients voluntarily accepted catgut embedding at Baliao and Xingfu One Acupuncture point. Before and after treatment, they were filled out the self-rating scale of defecation, including the data of defecation frequency, total defecation time, defecation effort, fecal texture, fecal characteristics and fecal incontinence, etc. <strong>Results:</strong> Compared with the baseline data, constipation was improved and fecal incontinence was disappeared. <strong>Conclusions:</strong> Catgut implantation at Baliao and Xingfu One Acupuncture Point is effectual for patients with neurogenic dysporia secondary to incomplete SCI.
文摘<strong>Background: </strong>Though anticholinergic drugs are considered the standard treatment for neurogenic detrusor overactivity, it is far from an ideal tool, because of their adverse effects such as Constipation or not respond sufficiently for a substantial proportion of patients. Recently mirabegron has become a commonly used overactive bladder medication in the general population, but few studies about mirabegron for the treatment of neurogenic detrusor overactivity. <strong>Objective:</strong> To evaluate the efficacy and safety of mirabegron for the treatment of neurogenic lower urinary tract dysfunction. <strong>Study Design:</strong> Prospective study. <strong>Methods:</strong> This prospective study included 13 adult patients with neurogenic lower urinary tract dysfunction as a result of spinal cord injury. All patients receiving mirabegron treatment (50 mg once daily) at least 6 weeks. The effective outcomes included the mean urine volume per catheterization, urinary incontinence episodes and Incontinence Specific Quality of Life Instrument. We monitored the blood pressure and heart rate to assess the cardiovascular safety, other adverse events were also recorded. <strong>Results:</strong> A total of 13 patients were included. After 6 weeks of treatment, all patients experienced a significant increase in the mean volume of per catheterization from 238.46 ± 65.43 ml to 327.69 ± 59.04 ml (p = 0.001). There is a significant reduction in the volume of urine leakage (463.85 ± 247.98 ml VS 180.00 ± 190.96 ml, p = 0.003) and incontinence episodes per 24 h (4.46 ± 2.03 VS 1.92 ± 1.50, p = 0.001). Significant improvement in mean Incontinence Specific Quality of Life Instrument was also found (p = 0.001). No patients reported dry mouth during the study, and the cardiovascular safety were acceptable. <strong>Conclusion:</strong> Mirabegron is safe and effective in the treatment of neurogenic lower urinary tract dysfunction. It might be a good choice for reducing the cessation of clean intermittent cathet
文摘<strong>Objective:</strong> The objective is to evaluate autonomic dysreflexia (AD) severity between urodynamics and cystoscopy in patients with spinal cord injury (SCI) above thoracic 6 (T6). <strong>Design:</strong> It is a cross-sectional survey. <strong>Subject and methods: </strong>The study was carried out in 22 patients with SCI above T6 who underwent both procedures of urodynamics and cystoscopy;all patients developed episodes of AD. The systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured and recorded at the beginning and during the various stages of the two examinations. AD was defined as a rise in SBP above 20 mm Hg. <strong>Results: </strong>There was no significant difference in SBP and DBP at baseline before urodynamics and cystoscopy. Both urodynamics and cystoscopy triggered episodes of AD. The volume of water instilled during cystoscopy was typically standard and smaller (150 mL) in comparison with urodynamics, where volume varied depending on cystometric bladder capacity (the mean bladder volume in our study was 234.86 ± 139.06 mL). The SBP was significantly different between cystoscopy and urodynamics (49.23 ± 23.07 mm Hg and 35.14 ± 15.75 mm Hg, respectively;P = 0.023). <strong>Conclusions: </strong>Although bladder distension during cystoscopy was less than that in urodynamics, the severity of AD was more pronounced during cystoscopy. It is recommended that monitoring of cardiovascular parameters during these procedures should be routinely performed.
文摘<strong>Objective:</strong> To evaluate the efficacy and safety of Combined detrusor and external urethral sphincter BTX-A injections for detrusor overactivity (DO) and detrusor external sphincter dyssynergia (DESD) secondary to spinal cord injury. <strong>Study Design:</strong> Prospective study. <strong>Methods:</strong> The study was carried out in 18 SCI patients with detrusor overactivity (DO) and detrusor external sphincter dyssynergia (DESD) receiving Combined detrusor and external urethral sphincter BTX-A injections treatment. Contain 200 U botulinum toxin intradetrusor and 100 U external urethral sphincter injections. The effective outcomes included maximum detrusor pressure at first DO and DESD (PdetmaxDO-DESD), volume at first DO and DESD (VDO-DESD), maximum urethral closure pressure (MUCP), and Incontinence-Specific Quality-of-Life Instrument (I-QoL). Adverse events were recorded. <strong>Results:</strong> All patients experienced a significant mean reduction in PdetmaxDO-DESD (50.75%), maximum urethral closure pressure (26.34%) and a significant mean increase in VDO-DESD (63.00%) 12-weeks post-injection. Significant (p < 0.001) improvement in mean Incontinence-Specific Quality-of-Life Instrument was also found. No obvious adverse event and toxic effect was observed. <strong>Conclusion:</strong> Combined detrusor and external urethral sphincter BTX-A injections is a good choice for patients with DO and DESD secondary to spinal cord injury. It could not only protect the upper urinary tract but also improve quality of life.
文摘<strong>Objective:</strong> Explore the rule of autonomic nervous dysfunction in the patients with urination disorder after high level spinal cord injury, and seek a safe, objective and accurate method to evaluate autonomic nervous function. <strong>Patients and Method:</strong> 48 patients with dysuria after cervicothoracic SCI were selected. Before, during and after imaging urodynamic examination with slow filling in supine position, blood pressure and ECG were monitored simultaneously. The symptoms of sweating, shivering, headache, flushing and chills were observed and recorded. The study of the relationship among the changes of blood pressure, heart rate and urodynamic indexes and the above symptoms was analyzed. <strong>Results:</strong> They were divided into three groups: group A (no obvious abnormality), group B (hyperactivity) and group C (hypoactivity) according to their BP, HR and existing the symptoms or not. <strong>Conclusion:</strong> The incidence of autonomic dysfunction in the high level SCI patients with dysuria was very high (79.17%), most of them were hyperactivity, and a few were low function. The changes of SBP and DBP in the hypoactivity group all appeared an increasing and then declining trend, while the change of HR in the low function one was lower than normal and decreased continuously. The main inducements of AD are neurogenic detrusor overactivity, detrusor sphincter dyssynergia, elevated abdominal pressure and abnormal bladder sensitivity. The asymptomatic patients had a higher occurrence rate (43.75%). Only by imaging urodynamic examination with slow filling and synchronous blood pressure monitoring, can autonomic nervous function of the patients be evaluated safely, objectively, early and accurately.
