Radiofrequency Sacral Rhizotomy for the Management of Intolerable Neurogenic Bladder in Spinal Cord Injured Patients
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Objective To investigate the eff ect of radiofrequency (RF) sacral rhizotomy of the intolerable neurogenic bladder in spinal cord injured patients. Method Percutaneous RF sacral rhizotomy was performed on 12 spinal cord injured patients who had neurogenic bladder manifested with urinary incontinence resisted to an oral and intravesical anticholinergic instillation treatment. Various combinations of S2, S3, and S4 RF rhizotomies were performed. Th e urodynamic study (UDS)was performed 1 week before RF rhizotomy. The voiding cystourethrogram (VCUG) and voiding diaries were compared 1 week before and 4 weeks after therapy. Total volume of daily urinary incontinence (ml/day) and clean intermittent catheterization (ml/time) volume of each time were also monitored. Results After RF sacral rhizotomy, bladder capacity increased in 9 patients and the amount of daily urinary incontinence decreased in 11 patients. The mean maximal bladder capacity increased from 292.5 to 383.3 ml (p<0.05) and mean daily incontinent volume decreased from 255 to 65 ml (p<0.05). Bladder trabeculation and vesicoureteral refl ux fi ndings did not change 4 weeks after therapy. Conclusion This study revealed that RF sacral rhizotomy was an effective method for neurogenic bladder with uncontrolled incontinence using conventional therapy among spinal cord injured patients.
Abstract
Objective To investigate the eff ect of radiofrequency (RF) sacral rhizotomy of the intolerable neurogenic bladder in spinal cord injured patients. Method Percutaneous RF sacral rhizotomy was performed on 12 spinal cord injured patients who had neurogenic bladder manifested with urinary incontinence resisted to an oral and intravesical anticholinergic instillation treatment. Various combinations of S2, S3, and S4 RF rhizotomies were performed. Th e urodynamic study (UDS)was performed 1 week before RF rhizotomy. The voiding cystourethrogram (VCUG) and voiding diaries were compared 1 week before and 4 weeks after therapy. Total volume of daily urinary incontinence (ml/day) and clean intermittent catheterization (ml/time) volume of each time were also monitored. Results After RF sacral rhizotomy, bladder capacity increased in 9 patients and the amount of daily urinary incontinence decreased in 11 patients. The mean maximal bladder capacity increased from 292.5 to 383.3 ml (p<0.05) and mean daily incontinent volume decreased from 255 to 65 ml (p<0.05). Bladder trabeculation and vesicoureteral refl ux fi ndings did not change 4 weeks after therapy. Conclusion This study revealed that RF sacral rhizotomy was an effective method for neurogenic bladder with uncontrolled incontinence using conventional therapy among spinal cord injured patients.
참고문헌 (20)
- Noronha-Blob L, "The anticholinergic activity of agents indicated for urinary incontinence is an important property for effective control do bladder dysfunction", J Pharmacol Exp Ther, 251, pp.586~593 (1989)
- Buyse G, "Intravesical oxybutynin for neurogenic bladder dysfunction: less systemic side eff ects due to reduced fi rst pass metabolism", J Urol, 160, pp.892~896 (1998)
- Schurch B, "Botulinum toxin type A is a safe and eff ective treatment for neurogenic urinary incontinence: results of a single treatment, randomized, placebo controlled 6-month study", J Urol, 174, pp.196~200 (2005)
- Ekstrom B, "Urodynamic effects of intravesical instillation of atropine and phentolamine in patients with detrusor hyperactivity", J Urol, 149, pp.155~158 (1993)
- Brindley GS, "The first 500 patients with sacral anterior root stimulator implants: general description", Paraplegia, 32, pp.795~805 (1994)
- Popovic MR, "Sacral root stimulation", Spinal Cord, 40, pp.431~ (2002)
- Kapural L, "Radiofrequency ablation for chronic pain control", Curr Pain Headache Rep, 5, pp.517~525 (2001)
- Mulcahy JJ, "Percutaneous radiofrequency sacral rhizotomy in the treatment of the hyperrefl exic bladder", J Urol, 120, pp.557~558 (1978)
- Mulcahy JJ, "Long-term follow-up of percutaneous radiofrequency sacral rhizotomy", Urol, 35, pp.76~77 (1990)
- Weibing S, "Relationship between the bladder trabeculation grades and pressure of detrusor in benign prostatic hyperplasia", China J Mod Med, 20, pp.723~725 (2010)
- Arnold EP, "Bladder function following spinal cord injury: a urodynamic analysis of the outcome", Br J Urol, 56, pp.172~177 (1984)
- Kim DY, "Intravesical neuromodulatory drugs: capsaicin and resiniferatoxin to treat the overactive bladder", J Endourol, 14, pp.97~103 (2000)
- de Seze M, "Intravesical capsaicin versus resiniferatoxin for the treatment of detrusor hyperreflexia in spinal cord injured patients: a double-blind, randomized, controlled study", 171, pp.251~255 (2004)
- 신지철, "척수 손상 환자의 신경인성 방광에서 방광 신장 치료법", Annals of Rehabilitation Medicine, 27(3), pp.9~348 (2003), 대한재활의학회
- Helmstein K, "Treatment of bladder carcinoma by a hydrostatic pressure technique", Br J Urol, 44, pp.434~450 (1972)
- Dunn M, "Interstitial cyctitis, treated by prolonged bladder distension", Br J Urol, 49, pp.641~645 (1977)
- Sluijter M, "Technical aspects of radiofrequency", Pain Pract, 2, pp.195~200 (2002)
- Blavias JG, "Pathophysiology of lower urinary tract dysfunction", Urol Clin North Am, 12, pp.215~224 (1985)
- Ferreira RS, "Percutaneous radiofrequency sacral rhizotomy in the treatment of neurogenic detrusor overactivity in spinal cord injured patients", Actas Urol Esp, 35, pp.325~330 (2011)
- Shin JC, "Clinical effectiveness of intravesical oxybutynin instillation in spinal cord injured patients with hyperrefl exic or hypertonic neurogenic bladder", J Korean Acad Rehabil Med, 24, pp.28~34 (2000)