Detrusor-External Sphincter Dyssynergia in Men with Multiple Sclerosis: An Omjnous Urologic Condition

Blaivas, Jerry G.; Barbalias, George A.

doi:10.1016/s0022-5347(17)50216-5

Cited by 104 publications

(66 citation statements)

References 16 publications

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“…The reported incidence of LUTS in patients with MS varies from a large scale. 15,16 The mechanism of DO is complex and depends on the coordination of both peripheral and CNS factors. Uncoordinated or disrupted signals along these pathways can lead to DO.…”

Section: Discussionmentioning

confidence: 99%

The clinical and urodynamic results of a 3‐month percutaneous posterior tibial nerve stimulation treatment in patients with multiple sclerosis‐related neurogenic bladder dysfunction

Kabay

Yücel

et al. 2009

Neurourology and Urodynamics

100

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Section: Discussionmentioning

confidence: 99%

The clinical and urodynamic results of a 3‐month percutaneous posterior tibial nerve stimulation treatment in patients with multiple sclerosis‐related neurogenic bladder dysfunction

Kabay

Yücel

et al. 2009

Neurourology and Urodynamics

100

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“…Detrusor-sphincter dyssynergia was classi®ed into three classes according to Blaivas and Barbalias criteria. 9 For patients with detrusor hyperre¯exia leak point pressure was also noted.…”

Section: Methodsmentioning

confidence: 99%

Autonomic dysreflexia during urodynamics

et al. 1998

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Autonomic dysre¯exia (AD) is an acute syndrome characterised by inappropriate and massive autonomic response that occurs in patients with spinal cord injury above the T6 level. Aims: to evaluate the incidence of AD during cystometry and the relationships with clinical and urodynamic features. Patients and methods: Forty-eight spinal cord injury patients were studied by neurological and urological examination and urodynamic evaluation with concurrent recording of blood pressure, heart rate and symptoms and signs of AD. Patients were considered to have AD if blood pressure reached values higher than 150/100 mmHg. Results: All the patients showed a signi®cant increase of both systolic and diastolic blood pressure, although only 20 showed pressure values higher than 150/100 mmHg (in seven of them without AD symptoms). AD was more frequent in cervical patients (P=0.034), but did not correlate with any other clinical features: sex ratio, age, disease duration, completeness of lesion, incidence of detrusor hyperre¯exia/are¯exia and detrusor-sphincter dyssynergia, voiding modalities, usage of anticholinergic drugs. In three patients blood pressure increase began when uninhibited contraction started, in 11 it was coincident with unhibited contraction peak and in the other six it appeared at maximum bladder capacity. Conclusions: (1) during urodynamic evaluation all the patients with lesion level above T6 showed signs of sympathetic stimulation, although only some showed dangerous blood pressure values; (2) the relationship between urodynamic data and dysre¯exia crisis shows that both the presence of detrusor uninhibited contractions and bladder distension are able to stimulate the crisis; (3) treatment with anticholinergic drugs is not sucient to prevent autonomic dysre¯exia starting from the bladder, unless it induces detrusor are¯exia. These patients are at risk of developing autonomic dysre¯exia following bladder distension.

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“…DSD was classi®ed into three classes according to Blaivas and Barbalias's criteria. 9 For patients with detrusor hyperre¯exia leak point pressure was also noted.…”

Section: Methodsmentioning

confidence: 99%

Clean intermittent catheterization and prevention of renal disease in spinal cord injury patients

et al. 1998

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Upper urinary tract complications have been reported in about 20 ± 30% of spinal cord injury patients. Their pathogenesis is linked to the presence of high-pressure uninhibited detrusor contractions, high leak point pressure and low bladder compliance. The aim of this study was to evaluate the incidence of upper urinary tract complications in two homogeneous groups of spinal cord injury patients with di erent bladder emptying modalities (intermittent catheterization vs. tapping, abdominal straining, Crede's manoeuvre) and the relationship with clinic and urodynamic features. A total of 17 patients (22%) had upper urinary tract complications. The incidence of both urinary tract dilatation and vesicoureteral re¯ux was signi®cantly lower in patients having intermittent catheterization (P=0.03 and 0.04 respectively). Intermittent catheterization thus seems to be e ective in preventing upper urinary tract disease in spinal cord injury patients requiring mechanical bladder emptying modalities. The ®nding of upper urinary tract complications also in patients having intermittent catheterization showing high intravesical pressures stresses the need of adding anticholinergic medications to the rehabilitation regimen of these patients.

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Detrusor-External Sphincter Dyssynergia in Men with Multiple Sclerosis: An Omjnous Urologic Condition

Cited by 104 publications

References 16 publications

The clinical and urodynamic results of a 3‐month percutaneous posterior tibial nerve stimulation treatment in patients with multiple sclerosis‐related neurogenic bladder dysfunction

The clinical and urodynamic results of a 3‐month percutaneous posterior tibial nerve stimulation treatment in patients with multiple sclerosis‐related neurogenic bladder dysfunction

Autonomic dysreflexia during urodynamics

Clean intermittent catheterization and prevention of renal disease in spinal cord injury patients

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