Comparison of urodynamics between ischemic and hemorrhagic stroke patients; Can we suggest the category of urinary dysfunction in patients with cerebrovascular accident according to type of stroke?

Han, Kyungsik; Heo, Sung Hyuk; Lee, Sun-Ju; Jeon, Seong Gyu; Yoo, Koo Han

doi:10.1002/nau.20708

Cited by 48 publications

(34 citation statements)

References 19 publications

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“…Untreated voiding symptoms may have a major negative impact on the quality of life of stroke patients and their relatives and are associated with a high mortality risk (3–5). LUTS are important to urologists and it is essential to evaluate detrusor function to manage LUTS in stroke patients (6). …”

Section: Introductionmentioning

confidence: 99%

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Usefulness of total bladder capacity and post-void residual urine volume as a predictor of detrusor overactivity with impaired contractility in stroke patients

Lee

Min

et al. 2012

Experimental and Therapeutic Medicine

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Detrusor overactivity (DO) with impaired contractility (DOIC) is a mixed pattern of involuntary contraction and increased post-void residual urine volume (PVR) which occurs in stroke patients. Urodynamic study results obtained from patients with detrusor abnormalities and stroke were analyzed to identify the associations between various urodynamic parameters and DOIC. Between August 2003 and November 2010, 127 patients were selected from 178 patients undergoing urodynamic study due to urinary symptoms. Stroke patients were divided into three groups: the DO, DOIC and detrusor underactivity (DU) groups. The significance of differences between the three groups was analyzed using the Kruskal-Wallis test and receiver operating characteristic (ROC) curves were used to calculate the accuracy of the urodynamic study result factors to distinguish between the three groups. The average total bladder capacity (TBC) was 219.15±98.30 ml in the DO, 330.25±115.75 ml in the DOIC and 486.00±111.48 ml in the DU (P<0.001) group. The average PVR was 22.64±20.85 ml in the DO, 146.87±95.09 ml in the DOIC and 425.33±136.70 ml in the DU (P<0.001) group. A ROC curve of DO and DOIC revealed that TBC and PVR were significantly different between the DOIC and DO groups. The area under the curve (AUC) of TBC was 0.812 (P<0.001) and that of PVR was 0.987 (P<0.001). A ROC curve of DOIC and DU revealed that TBC and PVR were significantly different between the DOIC and DU groups. The AUC of TBC was 0.813 (P<0.001) and that of PVR was 0.929 (P<0.001). In the urodynamic study of stroke patients with urinary symptoms, TBC and PVR may provide useful information for treating patients who cannot undergo urodynamic study.

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Section: Introductionmentioning

confidence: 99%

“…However, certain patients complain of voiding symptoms such as strain, weak stream and tenesmus (6). Stroke patients may experience storage and voiding symptoms together (7).…”

Section: Introductionmentioning

confidence: 99%

Usefulness of total bladder capacity and post-void residual urine volume as a predictor of detrusor overactivity with impaired contractility in stroke patients

Lee

Min

et al. 2012

Experimental and Therapeutic Medicine

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“…In urodynamischen Studien weisen etwa 31-33% der Patienten erniedrigte Harnröhrenver-schlussdrücke während der Speicherphase/Füllung auf [8,57] [38,47,67]). Patienten mit ischämischem Schlaganfall scheinen häu-figer eine DÜ als eine DHK aufzuweisen, während es bei Patienten mit hämorrha-gischen Schlaganfall umgekehrt zu sein scheint [28]. Eine DSD ist selten und tritt am ehesten bei Läsionen im Bereich der Basalganglien und Pons auf [58].…”

Section: Funktionsstörungen Des Uht Bei Msaunclassified

Neurourologische Funktionsstörungen des unteren Harntraktes bei Erkrankungen des ZNS

Mehnert

Nehiba

2012

Urologe

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The lower urinary tract (LUT) is regulated by a complex neural network that is subject to supraspinal control. Neurological disorders, especially of the central nervous system (CNS), can rapidly lead to disruption of this control. Multiple sclerosis, Parkinson's disease, multiple system atrophy, and stroke are neurological disorders which quite frequently cause dysfunction of the LUT. With respect to the pathophysiology of bladder dysfunction in CNS diseases there are various hypotheses regarding the individual disorders: disturbances of neural communication between the frontal cortex and pontine micturition center, between the pontine micturition center and the lumbosacral parts of the spinal cord, and between the basal ganglia, thalamus, and anterior cingulate gyrus appear to play a pivotal role in the development of bladder dysfunction. The symptoms and urodynamic presentation of LUT dysfunction can vary considerably depending on the disease and disease progression and can change in the course of the disease. The incidence and prevalence of LUT dysfunctions rise with increasing progression of the underlying neurological disease.Various conservative, minimally invasive, and open surgical procedures are available to prevent harmful sequelae and to improve the quality of life of these patients. As yet, however, few data exist on most of the treatment options in cases of the above-mentioned CNS diseases. Intermittent self-catheterization and antimuscarinic medications are among the most important conservative treatment options. Injection of botulinum neurotoxin type A into the detrusor muscle and increasingly sacral or pudendal neuromodulation are among the most important minimally invasive treatment options. Surgical methods include reconstructive continent or incontinent urinary diversion.When planning therapy the patient's current needs and neurological limitations as well as possible disease progression must be taken into consideration. It is often advisable to consult with and enlist the cooperation of the attending neurologist when planning treatment.

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“…Disfunção miccional pode estar presente em indivíduos com AVC isquêmico ou hemorrágico, podendo ser temporária ou permanente, dependendo do tamanho e da área de lesão. Sintomas urinários podem estar relacionados com afasias, déficit cognitivo, comportamental e motor 3,4 , os quais são relatados pelos profissionais de saúde, familiares e cuidadores para a avaliação da equipe de saúde se esta condição trata-se de disfunção do trato urinário inferior 5 . Através da utilização de métodos de imagem como tomografia computadorizada por emissão de fóton único (SPECT) para mapear as regiões que são ativadas durante o processo da micção, foram observadas atividades significativas no giro frontal inferior direito e giro do cíngulo anterior direito durante a fase da micção 6 .…”

Section: Introductionunclassified

Análise da relação entre sintomas urinários e topografia da lesão cerebral em pacientes com acidente vascular cerebral

Banaszeski¹,

Christo

2018

Cienc. Saude

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Observou-se que na ocorrência de lesões extensas acometendo a área frontal-parietal-temporal-occiptal (p=0,001), alterações cognitivas (p=0,001) e afasia (p=0,001) houve relação estatística significativa com a presença de incontinência urinária contínua nestes pacientes. Nos pacientes com lesão fronto-parietal houve associação com o sintoma urgência (p=0,050), urgeincontinência urinária (p=0,042), incontinência urinária de esforço (p=0,019) e polaciúria (p=0,042). Conclusão: Segundo a amostra estudada, observamos que alterações cognitivas e afasia tiveram correlação com a incontinência urinária contínua. Em relação a topografia de lesão cerebral houve associação entre lesões em região fronto-parietal com os sintomas de urgência, urgeincontinência, incontinência de esforço e polaciúria; e na ocorrência de lesão cerebral extensa houve prevalência de incontinência urinária contínua.Palavras-chave: acidente vascular cerebral; transtornos urinários; lesões cerebrais. ABSTRACT Objective: This study analyzed the relation between brain injury topography and bladder dysfunction in patients with ischemic and hemorrhagic stroke by comparing the brain region affected with lower urinary tract symptoms (LUTS

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Comparison of urodynamics between ischemic and hemorrhagic stroke patients; Can we suggest the category of urinary dysfunction in patients with cerebrovascular accident according to type of stroke?

Abstract: Evaluation of the stroke type may be helpful in the determination of the type of urinary dysfunction and in deciding the appropriate bladder management. The urodynamic study, however, is essential to manage LUTS in stroke patients.

Cited by 48 publications

References 19 publications

Usefulness of total bladder capacity and post-void residual urine volume as a predictor of detrusor overactivity with impaired contractility in stroke patients

Usefulness of total bladder capacity and post-void residual urine volume as a predictor of detrusor overactivity with impaired contractility in stroke patients

Neurourologische Funktionsstörungen des unteren Harntraktes bei Erkrankungen des ZNS

Análise da relação entre sintomas urinários e topografia da lesão cerebral em pacientes com acidente vascular cerebral

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