Intravesical Diamorphine for Bladder Spasm

McCoubrie, Rachel; Jeffrey, Jeffrey

doi:10.1016/s0885-3924(02)00602-4

Cited by 20 publications

(3 citation statements)

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“…Intravesical administration of morphine has been investigated in patients with varying results. In children undergoing vesico-ureteral surgery, Duckett et al (1997) demonstrated a pain-relieving effect in an open study, and an effect on bladder spasm of intravesical opioid has also been observed (McCoubrie and Jeffrey, 2003). However, in a controlled randomized study of postoperative pain in children undergoing vesico-ureteral surgery, no advantages of a continuous bladder infusion of morphine compared with placebo could be demonstrated (El-Ghoneimi et al, 2002).…”

Section: Peripheral Targetsmentioning

confidence: 99%

Pharmacology of the Lower Urinary Tract: Basis for Current and Future Treatments of Urinary Incontinence

Andersson

Wein²

2004

Pharmacol Rev

452

364

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Section: Peripheral Targetsmentioning

confidence: 99%

Pharmacology of the Lower Urinary Tract: Basis for Current and Future Treatments of Urinary Incontinence

Andersson

Wein²

2004

Pharmacol Rev

452

364

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“…While opioids and adjuvant medications, such as oxybutynin, have been the mainstay for treatment, persistent spasms may be resistant to many forms of treatment (1). Epidural opioids, intravesicular opioids and local anesthetics, and sacral nerve root rhizotomies have been described as treatment alternatives (2)(3)(4)(5)(6).…”

mentioning

confidence: 99%

The Use of Lumbar Sympathetic Blockade at L4 for Management of Malignancy-Related Bladder Spasms

Gulati

2011

Pain Phys

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Background: Cancer-related bladder spasms may be a rare but severe symptom of bladder or metastatic cancer or its related treatments. Various treatments described in the literature include systemic medications, intravesical or epidural medications, or even sacral neurolectomies. Objective: We present 3 patients who have suffered from bladder spasm either from invasion of the bladder wall by tumor (2 patients) or from intravesical chemotherapeutic treatment. Design: Case Report. Setting: Cancer pain management hospital. Methods: For each patient, we describe the use of lumbar sympathetic block to successfully treat the bladder spasms. Sympathetic blockade was performed at the left anterolateral border of lumbar vertebra L4. We used 10 mL of local anesthetic (0.25% bupivacaine) delivered in 2 mL aliquots, each given after negative aspiration for heme. Each procedure was performed with fluoroscopic guidance (both AP and lateral views) with the use of iodine contrast (Omnipaque-180) to confirm the location of the medication and its resulting spread. Results: All 3 patients had a reduction in the frequency and intensity of spasms, with 2 out of 3 patients not having a recurrence of the spasms for up to 2 months post procedure and follow up. Limitations: Case Report. Conclusion: Lumbar sympathetic blockade could be a useful treatment for recurrent bladder spasm in the oncologic population. Based on these findings, we feel that the branches of the sympathetic nerve set at L4 may be a good target for neurolytic procedures, such as radiofrequency ablation, for long term treatment of bladder spasms. Further research is necessary to determine the efficacy of this technique for the treatment of bladder spasms in the oncologic population. Key words: Bladder spasm, cancer pain, splanchnic nerve, lumbar sympathetic block

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“…Successful pain management following bladder surgery in children is often complicated by bladder spasm that may make it difficult to achieve adequate analgesia using standard techniques 1 .…”

mentioning

confidence: 99%