Autonomic hyperreflexia revisited.

Details

Serval ID
serval:BIB_07F5A9FFD3C0
Type
Article: article from journal or magazin.
Collection
Publications
Title
Autonomic hyperreflexia revisited.
Journal
Urologia Internationalis
Author(s)
Schurch B., Knapp P.A., Rossier A.B.
ISSN
0042-1138 (Print)
ISSN-L
0042-1138
Publication state
Published
Issued date
1997
Volume
58
Number
3
Pages
148-152
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Abstract
PURPOSE: To analyze autonomic hyperreflexia (AHR) associated with neurogenic bladder dysfunction in high spinal cord-injured patients.
MATERIAL AND METHODS: Sixty-five patients were examined using a new recording system. Seventeen suffered from a spinal cord lesion above the T5-T6 level and presented with neurogenic voiding disorders and AHR. Mean arterial pressure (MAP) changes were analyzed during 3 different urodynamic phases: bladder filling; isometric bladder contraction, and voiding.
RESULTS: Of the 17 tetraplegic and high paraplegic patients, 6 dropped out and 11 entered the study. Nine of these eleven patients displayed uninhibited bladder contractions and voiding. In these 9 cases MAP increased progressively during bladder contraction until a maximal bladder pressure was reached. An ongoing elevation of MAP was observed during voiding which returned to normal values within 5 min after micturition. In 2 patients detrusor-sphincter dyssynergia prevented voiding. As opposed to the 9 previously mentioned patients, maximal MAP occurred at or before the maximal bladder pressure in these 2 cases and decreased thereafter.
CONCLUSIONS: Evidence is presented that the posterior urethral receptors and their ascending pathway played a major role in the maintenance of AHR during micturition.
Keywords
Autonomic Nervous System Diseases/etiology, Autonomic Nervous System Diseases/physiopathology, Blood Pressure/physiology, Female, Humans, Male, Paraplegia/etiology, Paraplegia/physiopathology, Quadriplegia/etiology, Quadriplegia/physiopathology, Reflex, Abnormal/physiology, Spinal Cord Injuries/complications, Spinal Cord Injuries/physiopathology, Urinary Bladder/innervation, Urinary Bladder, Neurogenic/etiology, Urinary Bladder, Neurogenic/physiopathology, Urodynamics/physiology
Pubmed
Web of science
Create date
05/11/2014 12:12
Last modification date
20/08/2019 12:30
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