Dysfunction of lower urinary tract function in patients with spinal cord injury

Détails

ID Serval
serval:BIB_B097A5ED7512
Type
Partie de livre
Sous-type
Chapitre: chapitre ou section
Collection
Publications
Institution
Titre
Dysfunction of lower urinary tract function in patients with spinal cord injury
Titre du livre
Neurology of Sexual and Bladder Disorders, 1st Edition
Auteur(s)
Schurch B., Tawadros C., Carda S.
Editeur
Elsevier
Statut éditorial
Publié
Date de publication
21/05/2015
Editeur scientifique
Vodusek  D. B., Boller  F.
Série
Handbook of Clinical Neurology
Langue
anglais
Résumé
Over the past 50 years, the mortality for urorenal cause in patients with spinal cord injuries (SCI) has decreased from over 75% to 2.3%, as a result of dramatic improvements in the diagnosis and management of lower urinary tract dysfunction (LUTD). The aims of this chapter are to assess the physiopathology of upper and lower motor neuron lesion on bladder and sphincter function after SCI, to give an overview of required clinical and instrumental examination and to discuss treatment modalities. Videourodynamic examination plays a key role in the assessment and follow-up of LUTD in SCI patients, in conjunction with neurophysiological and radiological examinations. The cornerstone of bladder management in SCI is clean intermittent self-catheterization, but often other treatments are needed to achieve full continence, to reduce infections and stone formation, to protect the upper urinary tract from excessive bladder pressure, and to prevent chronic renal failure. Treatments may be pharmacologic (i.e., anticholinergic drugs and botulinum toxin) or surgical (by enterocystoplasty or urinary diversion). In selected cases, neuromodulation and sacral root stimulation can be used to reduce detrusor overactivity and empty the bladder. Management of LUTD in SCI patients requires a deep knowledge of spinal cord medicine and functioning of patients with neurologic disability.
Mots-clé
Anticholinergics, botulinum toxin, electric stimulation, physiopathology, spinal cord injuries, surgery, therapeutics, urinary catheterization, urodynamics.
Création de la notice
02/03/2015 8:16
Dernière modification de la notice
15/07/2020 5:26
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