Systemic and intrathecal pharmacologic treatment

Aharony, Shachar; Corcos, Jacques

doi:10.1201/b18585-44

Cited by 2 publications

(6 citation statements)

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“…The most commonly used medications are anticholinergics (antimuscarinics), and beta-3 agonists. Systemic medications, along with CISC, constitute the first-line management of NDO in SCI patients [13,29] . Follow up after starting the systemic medication is warranted, which includes follow-up of symptoms improvement and urodynamic study in 3 months [12] .…”

Section: Systemic Medications To Treat Neurogenic Detrusor Over-activitymentioning

confidence: 99%

“…The possible adverse reactions should be monitored, along with improvement in symptoms and urodynamic parameters. Common adverse reactions include dry mouth, dry eyes, constipation, blurred vision, cognitive impairment (confusion), prolonged Q-T interval, and headache [29] . Anticholinergics should be avoided in patients with glaucoma, myasthenia gravis, gastrointestinal obstruction, and severe ulcerative colitis [32] .…”

Section: Systemic Medications To Treat Neurogenic Detrusor Over-activitymentioning

confidence: 99%

“…Beta-3 agonists, mirabegron, the commercially available beta-3 agonist to treat detrusor overactivity, has been introduced recently. It acts on beta-3 receptors on the detrusor muscle to induce relaxation of the detrusor muscle [29] . Its use in NDO has been shown to increase the volume at the first detrusor contraction and to improve bladder compliance, with a non-significant increase in bladder capacity when compared to placebo [34] .…”

Section: Systemic Medications To Treat Neurogenic Detrusor Over-activitymentioning

confidence: 99%

“…The usual dose of Mirabegron is 25-50 mg/day, which can be increased to 100 mg/day [33] . The possible adverse reactions include hypertension, urinary tract infection, and headache [29] . The use of mirabegron is currently limited in neurogenic bladder patients, as limited evidence exists to support its use in this population [8,31] .…”

Section: Systemic Medications To Treat Neurogenic Detrusor Over-activitymentioning

confidence: 99%

“…The clinician should evaluate the response of Botulinum Toxin A 2-3 months with symptomatic and Table 4. Common antimuscarinic medications used in the treatment of NDO [12,29,60] Name urodynamic evaluation 2-3 months after the first injection and then if there is a change of clinical course and recurrence of symptoms despite recent injection [12,40] .…”

Section: Intravesical Injection Of Botulinum Toxinmentioning

confidence: 99%

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Evaluation, treatment, and surveillance of neurogenic detrusor overactivity in spinal cord injury patients

Alsulihem¹,

Corcos²

2019

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Neurogenic detrusor overactivity is a common urodynamic finding in patients with supra-sacral spinal cord injury. Early evaluation, stepped management, and close follow-up reduce the risk of upper urinary tract deterioration, renal failure and incontinence. In this article, we aim to outline the modern pathway of the management of this complex disease. Evaluation of patients with history, physical examination, renal function assessment, cystoscopy, and urodynamic study are essential. Management of neurogenic detrusor overactivity with adequate bladder drainage, medical therapy, intradetrusor botulinum injections, and surgery can be offered in a stepwise manner. Follow-up after specific interventions should be done in a timely fashion to detect treatment response and to avoid complications of poorly managed neurogenic detrusor overactivity.

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Section: Systemic Medications To Treat Neurogenic Detrusor Over-activitymentioning

confidence: 99%

Section: Systemic Medications To Treat Neurogenic Detrusor Over-activitymentioning

confidence: 99%

Section: Systemic Medications To Treat Neurogenic Detrusor Over-activitymentioning

confidence: 99%

Section: Systemic Medications To Treat Neurogenic Detrusor Over-activitymentioning

confidence: 99%

Section: Intravesical Injection Of Botulinum Toxinmentioning

confidence: 99%

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Evaluation, treatment, and surveillance of neurogenic detrusor overactivity in spinal cord injury patients

Alsulihem¹,

Corcos²

2019

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Transplanted Human Stem Cell-Derived Interneuron Precursors Mitigate Mouse Bladder Dysfunction and Central Neuropathic Pain after Spinal Cord Injury

et al. 2016

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Neuropathic pain and bladder dysfunction represent significant quality-of-life issues for many spinal cord injury patients. Loss of GABAergic tone in the injured spinal cord may contribute to the emergence of these symptoms. Previous studies have shown that transplantation of rodent inhibitory interneuron precursors from the medial ganglionic eminence (MGE) enhances GABAergic signaling in the brain and spinal cord. Here we look at whether transplanted MGE-like cells derived from human embryonic stem cells (hESC-MGEs) can mitigate the pathological effects of spinal cord injury. We find that 6 months after transplantation into injured mouse spinal cords, hESC-MGEs differentiate into GABAergic neuron subtypes and receive synaptic inputs, suggesting functional integration into host spinal cord. Moreover, the transplanted animals show improved bladder function and mitigation of pain-related symptoms. Our results therefore suggest that this approach may be a valuable strategy for ameliorating the adverse effects of spinal cord injury.

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Systemic and intrathecal pharmacologic treatment

Cited by 2 publications

References 1 publication

Evaluation, treatment, and surveillance of neurogenic detrusor overactivity in spinal cord injury patients

Evaluation, treatment, and surveillance of neurogenic detrusor overactivity in spinal cord injury patients

Transplanted Human Stem Cell-Derived Interneuron Precursors Mitigate Mouse Bladder Dysfunction and Central Neuropathic Pain after Spinal Cord Injury

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