Almost one-third of the patients with cerebral palsy and urinary symptoms presented with normal urodynamic findings. The most frequent findings were reduced bladder capacity, detrusor overactivity, and increased post-void residual. No urinary tract complications were observed.
Purpose: To assess the prevalence of LUTS, urinary tract and urodynamics changes in patients with Friedreich's Ataxia (FA), the most common form of hereditary ataxia. Materials and Methods:This study evaluated 258 patients with genetically confirmed diagnoses of FA. Of the patients, 158 responded to a questionnaire which assessed their urinary symptoms. Patients with clinical changes underwent renal function examinations, ultrasound, and urodynamic studies (UDS). Results: The sample analyzed showed that 82% of the patients complained of LUTS, although only 22% related the symptoms with quality of life impairment. Twenty eight (18%) of them agreed to undergo urodynamic evaluation. Urgency was the most common symptom. The exam was normal in 4 (14%) and detrusor underactivity was the most common finding. 14% (4 patients) presented with dilatation of the upper urinary tract at ultrasound scans. None of them had creatinine alterations. Conclusions: LUTS was found in a large percentage of patients with FA, but only a few related it to their quality of life impairment. Although creatinine levels was normal in this sample, some patients may show upper urinary tract abnormalities, with deserves close observation and proper care. Urinary Symptoms and Urodynamics Findings in
Purpose: To evaluate the efficacy of botulinum toxin type A injections in the detrusor muscle in patients with spinal cord injury and urinary incontinence due to detrusor overactivity and refractory to anticholinergic agents. Materials and Methods: We prospectively evaluated 22 patients with spinal cord injuries, whose bladders were emptied by intermittent catheterization. All patients had detrusor overactivity and urinary incontinence that proved difficult to treat, despite using high doses of two different anticholinergics. The pre-treatment assessment included a complete urodynamic study and ultrasonography of the kidneys and urinary tract. A one-month follow-up was completed with urodynamic evaluation and the clinical response was evaluated through outpatient consultations and telephone contact. Results: After the procedure, the maximum cystometric capacity and the bladder reflex volume increased, whereas the maximum detrusor pressure and compliance decreased. The mean duration of continence was 7 ± 7 months. In 18 patients (81.8%), it was necessary to administer anticholinergics to achieve continence. Five patients (22.7%) had indication of reinjection, and augmentation cystoplasty was indicated in 9 patients (40.9%). Conclusion:The use of botulinum toxin in the treatment of neurogenic detrusor overactivity refractory to anticholinergics is an option before more invasive treatments, such as augmentation cystoplasty, are attempted. In our study as well as in the literature, there was improvement in most urodynamic parameters. Overall, 40.9% of patients underwent augmentation cystoplasty and 81.8% of patients needed anticholinergic agents to reach urinary continence. Further studies are necessary to improve the procedure and to achieve better clinical results.
Introduction: Aneurysmal bone cyst is a benign and destructive bone lesion of unknown etiology. Current approaches to treatment include surgical en bloc excision, curettage, selective arterial embolization and radiotherapy. A giant aneurysmal bone cyst in the lumbar vertebra is reported, along with a brief review of the literature on the topic. Method:A 15-yearold boy presents with lumbar pain and a 3 months history of paraparesis. Diagnostic imaging revealed an expansile lytic lesion in the spinous process and lamina of the fourth and fifth lumbar vertebra. Surgical treatment consisted of excisional biopsy and a segmental instrumented posterior fusion from L2-S1. Histopathology was consistent with an aneurysmal bone cyst. After one year, the patient improved his neurological function with only a L5 bilateral paresis. Discussion: Treatment of aneurysmal bone cysts of the spine is challenging when it occurs in close proximity to neural and vascular structures. Fusion and stabilization with instrumentation are often necessary. One vertebra is involved in most cases and extensive lesions are uncommon. Complete tumor resection and fusion of lumbar spine, using stabilization with instrumentation provide both cure and preservation of lumbar spine stability. Neurological deficits can be improved by surgical removal of the tumor
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.