Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 2.667
Filter
1.
Spinal Cord Ser Cases ; 10(1): 40, 2024 Jun 04.
Article in English | MEDLINE | ID: mdl-38834538

ABSTRACT

INTRODUCTION: Women of childbearing age make up around 5-10% of individuals with spinal cord injury (SCI) and may face unique medical and functional complications during pregnancy, including prolonged hospitalization and increased risk of early rehospitalization due to falls. CASE PRESENTATION: Here, we discuss a case of a young ambulatory woman with a lumbar motor incomplete spinal cord injury who underwent successful delivery via cesarean section and the role of the physiatrist in the management of the patient's antepartum, intrapartum, and postpartum complications. The patient faced significant antepartum challenges secondary to her neurogenic bladder and pelvic floor weakness, resulting in increased use of her manual wheelchair. The physiatry team assisted with the co-development of a multidisciplinary bladder plan for increased urinary frequency and urinary tract infection prevention with the patient's obstetrics physician (OB). In addition, the physiatry team assisted with the procurement of a new wheelchair suited for the patient's pregnancy and childcare needs in anticipation of decreased mobility during this time. Regarding intrapartum challenges, the physiatry team worked with the patient and her OB to develop a safe birth plan considering the method of delivery, epidural usage, and the need for pelvic floor therapy before and after childbirth. DISCUSSION: The patient had a successful cesarean section delivery, with return to independent mobility soon after childbirth. In summary, this case demonstrates that there is a need for a multidisciplinary approach to patients with SCI during pregnancy and that the role of physiatry is critical to optimizing medical and functional outcomes.


Subject(s)
Cesarean Section , Pregnancy Complications , Spinal Cord Injuries , Humans , Female , Pregnancy , Spinal Cord Injuries/complications , Spinal Cord Injuries/therapy , Pregnancy Complications/therapy , Adult , Cesarean Section/methods , Lumbar Vertebrae , Physical and Rehabilitation Medicine/methods , Urinary Bladder, Neurogenic/therapy , Urinary Bladder, Neurogenic/etiology , Delivery, Obstetric/methods
2.
Urol Clin North Am ; 51(2): 163-176, 2024 May.
Article in English | MEDLINE | ID: mdl-38609189

ABSTRACT

The Neurogenic Bladder Research Group (NBRG) was formed with the mission to optimize quality of life (QoL), surgical outcomes, and clinical care of patients with neurogenic lower urinary tract dysfunction. One of the original priorities of the organization was to support creation of the NBRG Spinal Cord Injury (SCI) Registry. The aim of this Registry was to establish a prospective database, in order to study bladder-related QoL after SCI. The study enrolled close to 1500 participants from across North America over an 18 month time-period (January 2016-July 2017).


Subject(s)
Spinal Cord Injuries , Urinary Bladder, Neurogenic , Humans , Urinary Bladder , Urinary Bladder, Neurogenic/etiology , Urinary Bladder, Neurogenic/therapy , Quality of Life , Registries
3.
Urol Clin North Am ; 51(2): 277-284, 2024 May.
Article in English | MEDLINE | ID: mdl-38609199

ABSTRACT

Individual and social factors are important for clinical decision-making in patients with neurogenic bladder secondary to spinal cord injury (SCI). These factors include the availability of caregivers, social infrastructure, and personal preferences, which all can drive bladder management decisions. These elements can be overlooked in clinical decision-making; therefore, there is a need to elicit and prioritize patient preferences and values into neurogenic bladder care to facilitate personalized bladder management choices. For the purposes of this article, we review the role of guideline-based care and shared decision-making in the SCI population with neurogenic lower urinary tract dysfunction.


Subject(s)
Spinal Cord Injuries , Urinary Bladder, Neurogenic , Humans , Urinary Bladder , Urinary Bladder, Neurogenic/etiology , Urinary Bladder, Neurogenic/therapy , Patient Preference , Clinical Decision-Making , Spinal Cord Injuries/complications , Spinal Cord Injuries/therapy
5.
Pediatr Surg Int ; 40(1): 111, 2024 Apr 20.
Article in English | MEDLINE | ID: mdl-38641738

ABSTRACT

BACKGROUND: Long-term urinary outcomes after anorectal malformation (ARM) repair are affected by surgical approach and sacral anomalies. This study aimed to compare laparoscopic-assisted anorectoplasty (LAARP) and posterior sagittal anorectoplasty (PSARP) in terms of urinary complications. METHODS: Between 2001 and 2022, 45 patients were treated with LAARP or PSARP. The rectourethral fistula and inflow angle between the fistula and rectum was confirmed by preoperative colonography. The incidence of urinary complications and treatment were compared between the two groups. RESULTS: Four patients (14%) had remnant fistula and five patients (17%) had neurogenic bladder dysfunction in LAARP group, while three patients (18%) had urethral injury in PSARP group. All patients with remnant fistula were asymptomatic and followed without treatment. The incidence of remnant fistula improved between earlier decade and later decade. In all cases with urethral injury, suture repair was performed and no postoperative leakage was noted. All five patients with neurogenic bladder dysfunction had spine abnormalities that required clean intermittent catheterization (CIC) and two were free from CIC finally. CONCLUSIONS: It is important to check inflow angle preoperatively to prevent remnant fistula. For PSARP, meticulous dissection is required when separating fistula from urethra because they create common wall. The most contributing factor to neurogenic bladder is sacral anomalies. Preoperative evaluation and postoperative urinary drainage are important.


Subject(s)
Anorectal Malformations , Laparoscopy , Rectal Fistula , Urethral Diseases , Urinary Bladder, Neurogenic , Urinary Fistula , Humans , Infant , Rectum/surgery , Rectum/abnormalities , Anorectal Malformations/complications , Anorectal Malformations/surgery , Anorectal Malformations/epidemiology , Urinary Bladder, Neurogenic/etiology , Laparoscopy/adverse effects , Treatment Outcome , Rectal Fistula/surgery , Rectal Fistula/complications , Urinary Fistula/etiology , Urinary Fistula/surgery , Urethral Diseases/etiology , Urethral Diseases/surgery , Postoperative Complications/etiology , Urethra/surgery , Retrospective Studies , Anal Canal/abnormalities
6.
Pediatr Surg Int ; 40(1): 114, 2024 Apr 29.
Article in English | MEDLINE | ID: mdl-38683501

ABSTRACT

INTRODUCTION: Spinal dysraphism is the most frequent cause of neurogenic bladder. Urodynamic study (UDS) is an important component of the follow-up of a child with neurogenic bladder. However, it suffers from a lack of widespread availability and is further hampered by technical difficulties and difficulty in its interpretation in children. A neurogenic bladder often appears vertically elongated; only limited and sparse literature is available regarding objectively defining the bladder shape and the urodynamic parameters in the cohort. OBJECTIVES: This study aimed to investigate the usefulness of the bladder's height-to-width ratio (HWR) on cystogram as a screening tool for identifying "non-physiological" bladder pressures in children with spinal dysraphism. A prospective study was undertaken to evaluate children operated for spinal dysraphism. Cystogram, ultrasonography and UDS evaluation were performed. HWR was calculated by the ratio of the maximum height to the maximum bladder width at maximum cystometric capacity (MCC), where MCC was calculated using standard Koff's formula, given by (age in years + 2) *30 ml in children more than one year and weight *7 ml for infants. The children were categorised into groups based on maximum detrusor pressure (MDP) into two groups (MDP ≥ 30 cmH2O and MDP < 30 cmH2O). A receiver-operative characteristic curve was constructed to analyse the sensitivity and specificity of HWR in predicting the MDP. RESULTS: A total of 53 children, operated for spinal dysraphism, met the study criteria during the study period, from March 2021 to September 2022. The median age of children was 4 years (IQR-3-5.5 years). The HWR ratio was compared between the two groups and was significantly higher for the non-physiological pressure bladders than for physiological pressure bladders (mean of 1.55 vs 1.26, p = 0.001). On evaluating the sensitivity and specificity of HWR for discerning children with non-physiological bladder pressures were 87.5% and 48.28%, respectively. The area under the curve (AUC) was 0.781, with a cut-off value of 1.3. DISCUSSION: We attempted to evaluate the HWR based on bladder shape objectively. We demonstrated a moderate correlation between the bladder shape and the bladder pressures. An HWR of 1.3 or higher could be significant for identifying a non-physiological bladder storage pressure. CONCLUSION: The height to width ratio of the bladder on cystogram is a useful tool as a surrogate marker for non-physiological storage pressures in bladders of children with spinal dysraphism.


Subject(s)
Spinal Dysraphism , Urinary Bladder, Neurogenic , Urinary Bladder , Urodynamics , Humans , Prospective Studies , Urinary Bladder/physiopathology , Urinary Bladder/diagnostic imaging , Female , Child, Preschool , Male , Urodynamics/physiology , Spinal Dysraphism/physiopathology , Spinal Dysraphism/complications , Spinal Dysraphism/diagnostic imaging , Child , Urinary Bladder, Neurogenic/physiopathology , Urinary Bladder, Neurogenic/etiology , Infant , Cystography/methods , Ultrasonography/methods , Pressure
7.
Spinal Cord Ser Cases ; 10(1): 30, 2024 Apr 25.
Article in English | MEDLINE | ID: mdl-38664389

ABSTRACT

INTRODUCTION: Acute transverse myelitis (ATM) is a rare neurological complication of Coronavirus disease (COVID-19) vaccines. Various vaccines have been linked to ATM, such as non-replicating viral vectors, ribonucleic acid, and inactivated vaccines. An ATM case is presented here involving the BNT162b2 vaccine leading to asymmetrical incomplete paraplegia and neurogenic bladder. CASE PRESENTATION: A 66-year-old male developed urinary retention one day after his second dose of the BNT162b2 vaccine, followed by rapidly progressing lower limb weakness. Clinical examination showed asymmetrical paraparesis, reduced sensation below the T8 level, including perianal sensation, and loss of ankle and anal reflexes. Laboratory tests were largely unremarkable, while the spine MRI revealed thickened conus medullaris with a mild increase in T2/STIR signal intensity and subtle enhancement post gadolinium. Following treatment with methylprednisolone, plasmapheresis, and immunoglobulin, and a rehabilitation program, the patient achieved good motor and sensory recovery, but the bladder dysfunction persisted. Single-channel cystometry indicated neurogenic detrusor underactivity and reduced bladder sensation, as evidenced by low-pressure and compliant bladder. The urethral sphincter appeared intact or overactive. The post-void residual urine was significant, necessitating prolonged intermittent catheterisation. DISCUSSION: Bladder dysfunction due to the COVID-19 vaccine-associated ATM is not as commonly reported as motor or sensory deficits. To our knowledge, this is the first case to highlight a neurogenic bladder that necessitates prolonged intermittent catheterisation as a consequence of COVID-19 vaccine-associated ATM. This report highlights the rare complication of the neurogenic bladder resulting from the BNT162b2 vaccine. Early detection and treatment are crucial to prevent long-term complications.


Subject(s)
BNT162 Vaccine , COVID-19 Vaccines , Myelitis, Transverse , Urinary Bladder, Neurogenic , Humans , Male , Myelitis, Transverse/etiology , Aged , Urinary Bladder, Neurogenic/etiology , Urinary Bladder, Neurogenic/therapy , BNT162 Vaccine/adverse effects , COVID-19 Vaccines/adverse effects , COVID-19/complications
8.
Clin Nephrol ; 101(6): 298-307, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38629744

ABSTRACT

BACKGROUND: Previous studies have indicated that creatinine (Cr)-based glomerular filtration rate (GFR) estimating equations - including the new Chronic Kidney Disease Epidemiology creatinine (CKD-EPIcr) equation without race and the estimated glomerular filtration rate (eGFR) equation developed for the Chinese population - displayed suboptimal performance in patients with neurogenic lower urinary tract dysfunction (NLUTD), which limited their clinical application for detecting changes in GFR levels in all cohorts. OBJECTIVE: To develop a neural network model based on multilayer perceptron (MLP) for evaluating GFR in Chinese NLUTD patients, and compare the diagnostic performance with Cr-based multiple linear regression equations for Chinese and the CKD-EPIcr equation without race. DESIGN: Single-center, cross-sectional study of GFR estimation from serum Cr, demographic data, and clinical characteristics in Chinese patients with NLUTD. PATIENTS: A total of 204 NLUTD patients, from 27 different geographic regions of China, were selected. A random sample of 141 of these subjects was included in the training sample set, and the remaining 63 patients were included in the testing sample set. METHODS: The reference GFR (rGFR) was assessed by the technetium-99m-labeled diethylenetriaminepentaacetic acid (99mTc-DTPA) double plasma sample method. A neural network model based on MLP was developed to evaluate GFR in the training sample set, which was then validated in the testing sample set and compared with Cr-based GFR equations. RESULTS: The MLP-based model showed significant performance improvement in evaluating the difference, absolute difference, precision, and accuracy of GFR estimation compared with the Cr-based GFR equations. Additionally, compared with the rGFR, we found that the MLP-based model provided an acceptable level of accuracy (greater than 85%, which was within a 30% deviation from the rGFR). CONCLUSION: The MLP-based model offered significant advantages in estimating GFR in Chinese NLUTD patients, and its application could be suggested in clinical practice.


Subject(s)
Creatinine , Glomerular Filtration Rate , Neural Networks, Computer , Humans , Female , Male , Middle Aged , Cross-Sectional Studies , Adult , Creatinine/blood , China/epidemiology , Aged , Urinary Bladder, Neurogenic/physiopathology , Urinary Bladder, Neurogenic/etiology , Urinary Bladder, Neurogenic/diagnosis , Urinary Bladder, Neurogenic/blood , Renal Insufficiency, Chronic/physiopathology , Renal Insufficiency, Chronic/diagnosis , Renal Insufficiency, Chronic/blood , Renal Insufficiency, Chronic/complications , Technetium Tc 99m Pentetate
9.
Brain Nerve ; 76(3): 261-271, 2024 Mar.
Article in Japanese | MEDLINE | ID: mdl-38514107

ABSTRACT

Here we reviewed bladder dysfunction in neurological diseases. Diseases of the brain cause overactive bladder (OAB); peripheral neuropathy including lumbar spondylosis results in postvoid residual; and spinal cord diseases cause a combination of OAB and postvoid residual. Multiple system atrophy mimics bladder dysfunction related to spinal cord disease. Conversely, in cases of bladder dysfunction of unknown etiologies, the underlying disease can be identified by the bladder dysfunction pattern. Aging also causes nocturnal polyuria. The collaboration between neurologists and urologists is highly recommended to maximize the quality of life of neurological patients.


Subject(s)
Neurology , Urinary Bladder, Neurogenic , Urinary Bladder, Overactive , Humans , Urinary Bladder, Neurogenic/diagnosis , Urinary Bladder, Neurogenic/etiology , Urinary Bladder , Quality of Life , Aging , Urinary Bladder, Overactive/diagnosis , Urinary Bladder, Overactive/complications
10.
Neurourol Urodyn ; 43(4): 811-817, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38451038

ABSTRACT

INTRODUCTION: Neurogenic detrusor overactivity (NDO) has a major impact on patients' quality of life and can lead to upper urinary tract complications. Intradetrusor botulinum toxin type A injections are administered as second-line treatment to these patients following the failure of anticholinergic agents. The aim of the DETOX 2 study is to propose a consensus definition of the failure of intradetrusor botulinum toxin injections for NDO in patients presenting spinal cord injury, spina bifida, or multiple sclerosis (MS) with self-catheterization. METHOD: This study followed the method adopted by the French National Authority for Health for recommendations by consensus. Based on a review of the literature and a preliminary survey, a steering committee compiled a questionnaire and selected a rating group comprising 16 experts from the Neuro-Urology Committee of the French Urology Association (cnuAFU) and Genulf. The experts were asked to complete the online questionnaire. At the end of the first round, all participants came together to discuss any disagreements and a second-round online questionnaire was completed to reach a consensus. RESULTS: Thirteen of the 16 experts approached completed both rounds of questionnaires. A strong consensus was reached for two proposals (median score = 9/10) which were therefore included in the definition from the first round: at least one repeat injection of the same botulinum toxin at the same dose must be given to rule out failure on technical grounds and a duration of efficacy <3 months must be considered a failure. At the end of round 2, a relative consensus was reached regarding the clinical criterion defining failure (median score = 7/10) and the urodynamic criterion of failure (median score = 8/10). An additional proposal was selected during this second round on the need for a voiding diary (median score = 8/10). CONCLUSION: The first consensus definition of failure of an intradetrusor injection of TB-A for NDO has been achieved with this study: persistence of detrusor overactivity with maximum detrusor pressures >40 cm H2O and/or a compliance issue and/or persistence of urinary incontinence and/or urgency and/or a number of daily self-catheterizations >8/day and/or efficacy <3 months. This study will help to standardize research on the failure of the intradetrusor botulinum toxin for NDO in clinical practice and clinical research.


Subject(s)
Botulinum Toxins, Type A , Neuromuscular Agents , Urinary Bladder, Neurogenic , Urinary Bladder, Overactive , Urinary Incontinence , Humans , Botulinum Toxins, Type A/therapeutic use , Quality of Life , Urinary Bladder, Neurogenic/etiology , Urinary Bladder, Overactive/drug therapy , Urinary Incontinence/complications , Neuromuscular Agents/therapeutic use , Treatment Outcome , Urodynamics
11.
Article in Russian | MEDLINE | ID: mdl-38549408

ABSTRACT

OBJECTIVE: To evaluate the clinical efficacy of long-term spinal and sacral programmable neurostimulation for pelvic organ dysfunction in patients with myelodysplasia and chronic dysfunction of the bladder and rectum. MATERIAL AND METHODS: A retrospective study included 32 children aged 1-17 years (mean 10.7) with myelodysplasia, pelvic organ dysfunction and ineffective therapy including botulinum therapy and exclusion of tethered spinal cord syndrome. All children underwent comprehensive urodynamic examination with analysis of bladder and residual urine volume, mean flow rate, intravesical pressure and total urine volume, as well as electromyographic examination. Examination was carried out before surgery, after 6, 12 and 36 months. We applied urinary diary, NBSS questionnaire and urodynamic examination data. All patients underwent neurological examinations (neurological status, magnetic resonance imaging of the spinal cord, computed tomography and radiography of the spine, electroneuromyography). The study was conducted at the neurosurgical department of the Republican Children's Clinical Hospital in Ufa between 2014 and 2022. There were 32 implantations of epidural neurostimulators for pelvic organ dysfunctions. RESULTS: Patients used epidural spinal and sacral stimulation up to 6 times a day for 10-15 min turning on the pulse generator. This method significantly increased urinary volume, decreased episodes of urinary leakage and fecal incontinence, residual volume after urination and number of periodic catheterizations compared to baseline data. Sixteen patients were very satisfied, 10 ones were moderately satisfied, and 2 patients were not satisfied with therapy. The number of bladder catheterizations per day decreased by 51.1%. Urine volume significantly increased from 131.5±16.1 to 236±16.7 ml, intravesical pressure decreased from 23.5±4.2 to 18.5±2.1 cm H2O (by 20.3%). CONCLUSION: Chronic epidural spinal and sacral stimulation can improve the quality of life in patients with pelvic organ dysfunction. This technique may be effective for pelvic organ dysfunction caused by myelodysplasia.


Subject(s)
Electric Stimulation Therapy , Urinary Bladder, Neurogenic , Child , Humans , Quality of Life , Retrospective Studies , Multiple Organ Failure/complications , Multiple Organ Failure/therapy , Urinary Bladder, Neurogenic/etiology , Urinary Bladder, Neurogenic/therapy , Sacrum/diagnostic imaging , Treatment Outcome , Electric Stimulation Therapy/adverse effects , Electric Stimulation Therapy/methods
12.
Neurourol Urodyn ; 43(4): 1019-1024, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38516982

ABSTRACT

Children with a neurogenic bladder are at risk of developing recurrent urinary tract infections and long-term kidney failure. Due to an altered lower urinary tract, children may be overtreated for simple bacteriuria or undertreated for a potentially severe urinary tract infection. This group of patients represent high users of healthcare, and are at risk of colonization and development of antibiotic resistance. Bladder washouts with non-antibiotic electrochemically activated solutions are a potential new prophylactic option for patients with bladder dysfunction when clean intermittent catheterization has resulted in chronic bacteriuria.


Subject(s)
Bacteriuria , Intermittent Urethral Catheterization , Urinary Bladder, Neurogenic , Urinary Tract Infections , Child , Humans , Urinary Bladder, Neurogenic/etiology , Urinary Bladder , Urinary Tract Infections/etiology , Urinary Catheterization/adverse effects
13.
Neurourol Urodyn ; 43(5): 1207-1216, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38533637

ABSTRACT

AIMS: Activation of the endocannabinoid system by monoacylglycerol lipase (MAGL) blockade may affect the lower urinary tract function. We investigated the effect of an MAGL inhibitor, MJN110, on neurogenic lower urinary tract dysfunction (LUTD) in the mouse model of spinal cord injury (SCI). METHODS: Female C57BL/6 mice that underwent spinal cord transection at T8-10 level were divided into three groups consisting of (1) vehicle-treated SCI mice, (2) 5 mg/kg, or (3) 10 mg/kg of MJN110-treated SCI mice. MJN110 and vehicle were administered intraperitoneally for 7 days from 4 weeks after spinal cord transection. We then conducted awake cystometrograms and compared urodynamic parameters between three groups. The expression of cannabinoid (CB) receptors, TRP receptors, and inflammatory cytokines in L6-S1 dorsal root ganglia (DRG) or the bladder mucosa were evaluated and compared among three groups. Changes in the level of serum 2-arachidonoylglycerol (2-AG) and bladder MAGL were also evaluated. RESULTS: In the cystometrogram, detrusor overactivity (DO) parameters, such as the number of nonvoiding contraction (NVC), a ratio of time to the 1st NVC to intercontraction interval (ICI), and NVC integrals were improved by MJN110 treatment, and some effects were dose dependent. Although MJN110 did not improve voiding efficiency, it decreased bladder capacity, ICI, and residual urine volume compared to vehicle injection. MJN110 treatment groups had lower CB2, TRPV1, TRPA1, and inflammatory cytokines mRNA levels in DRG and bladder mucosa. Serum 2-AG was increased, and bladder MAGL was decreased after MAGL inhibitor treatment. CONCLUSIONS: MAGL inhibition improved LUTD including attenuation of DO after SCI. Thus, MAGL can be a therapeutic target for neurogenic LUTD after SCI.


Subject(s)
Mice, Inbred C57BL , Monoacylglycerol Lipases , Spinal Cord Injuries , Urinary Bladder , Urodynamics , Animals , Monoacylglycerol Lipases/antagonists & inhibitors , Monoacylglycerol Lipases/metabolism , Spinal Cord Injuries/physiopathology , Spinal Cord Injuries/drug therapy , Spinal Cord Injuries/complications , Spinal Cord Injuries/metabolism , Female , Urinary Bladder/drug effects , Urinary Bladder/physiopathology , Urodynamics/drug effects , Mice , Disease Models, Animal , Ganglia, Spinal/drug effects , Ganglia, Spinal/metabolism , Ganglia, Spinal/physiopathology , Receptors, Cannabinoid/metabolism , Receptors, Cannabinoid/drug effects , Enzyme Inhibitors/pharmacology , Endocannabinoids/metabolism , Cytokines/metabolism , Urinary Bladder, Neurogenic/drug therapy , Urinary Bladder, Neurogenic/physiopathology , Urinary Bladder, Neurogenic/etiology , Lower Urinary Tract Symptoms/drug therapy , Lower Urinary Tract Symptoms/physiopathology , Lower Urinary Tract Symptoms/etiology , Carbamates , Succinimides
14.
BMC Urol ; 24(1): 37, 2024 Feb 12.
Article in English | MEDLINE | ID: mdl-38347524

ABSTRACT

BACKGROUND: The Short Form Qualiveen (SF-Qualiveen) questionnaire assesses the effect of bladder and urinary symptoms on patients' quality of life (QoL) with urological impairment caused by neurological diseases. There is no validated SF-Qualiveen questionnaire in Arabic, so this study aims to provide a translated and validated version of the SF-Qualiveen questionnaire among Arabic-speaking patients with multiple sclerosis (MS). METHODS: The English version of the SF-Qualiveen was translated into Arabic using an algorithm for linguistic and cultural adaptation. MS patients completed the SF-Qualiveen, and the Neurogenic Bladder Symptom Score(NBSS) questionnaire. Psychometric features such as content and construct validity, test-retest reliability, and internal consistency were analyzed. Construct validity was evaluated by contrasting the SF-Qualiveen with the NBSS questionnaire. Internal consistency was measured using Cronbach's alpha, whereas the intraclass correlation coefficient (ICC) was employed to assess the test-retest reliability. RESULTS: One hundred and two patients with MS were included in this study. The internal consistency of the total SF-Qualiveen, and the domains "Bother with limitations," "Fear," "Feeling," and "Frequency of limitations" showed good internal consistency (Cronbach's alpha of > 0.7). ICC was 0.91 for the total score 0.85 for the Bother with limitations, 0.81 for Fears, 0.86 for Feeling, and 0.81 for Frequency of limitations. The correlation analysis revealed a positive association between the total scores on the NBSS and the domains of the SF-Qualiveen, comprising bother with limitations (r = 0.473, p = 0.027), fears (r = 0.611, p = 0.031), feelings (r = 0.572, p = 0.04), and frequency of limitations (r = 0.514, p = 0.013). CONCLUSIONS: The findings of this validation study revealed that the SF-Qualiveen is a reliable and valid instrument appropriate for Arabic-speaking patients with MS in both research and clinical practice.


Subject(s)
Multiple Sclerosis , Urinary Bladder, Neurogenic , Humans , Quality of Life , Multiple Sclerosis/complications , Multiple Sclerosis/diagnosis , Cross-Cultural Comparison , Reproducibility of Results , Urinary Bladder, Neurogenic/diagnosis , Urinary Bladder, Neurogenic/etiology , Surveys and Questionnaires , Psychometrics
15.
J Orthop Surg Res ; 19(1): 56, 2024 Jan 12.
Article in English | MEDLINE | ID: mdl-38217026

ABSTRACT

BACKGROUND: The Short-Form Qualiveen (SF-Qualiveen) questionnaire assesses the effect of bladder and urinary symptoms on patients' quality of life (QoL) with urological impairment caused by neurological diseases. There is no validated SF-Qualiveen questionnaire in Arabic, so this study aims to provide a translated and validated version of the SF-Qualiveen questionnaire among Arabic patients experiencing spinal cord injury (SCI). METHODS: Psychometric features such as content and construct validity, test-retest reliability, and internal consistency were analyzed. Construct validity was evaluated by contrasting the SF-Qualiveen with the Neurogenic Bladder Symptom Score Short-Form (NBSS-SF) questionnaire. Internal consistency was measured using Cronbach's alpha, whereas the intraclass correlation coefficient (ICC) was employed to assess the test-retest reliability. Factorial validity was established by principal component analysis (PCA). RESULTS: The internal consistency of the total SF-Qualiveen and the domains "Bother with limitations," "Fear," "Feeling," and "Frequency of limitations" showed good internal consistency (Cronbach's alpha of > 0.7). ICC was 0.90 for the total score, 0.83 for the bother with limitations, 0.80 for fears, 0.84 for feeling, and 0.81 for frequency of limitations. The correlation analysis revealed a positive association between the total scores on the NBSS-SF and the domains of the SF-Qualiveen, comprising bother with limitations (r = 0.53, p = 0.02), fears (r = 0.44, p = 0.03), feelings (r = 0.49, p = 0.04), and frequency of limitations (r = 0.46, p = 0.02). The best-fit four-factor model for confirming overall item communalities ranged from 0.552 to 0.814, which indicates moderate to high communalities, and confirms the homogeneity of the SF-Qualiveen using PCA. CONCLUSIONS: The findings of this validation study revealed that the SF-Qualiveen is a reliable and valid instrument appropriate for Arabic-speaking patients with SCI in both research and clinical practices.


Subject(s)
Spinal Cord Injuries , Urinary Bladder, Neurogenic , Humans , Quality of Life , Reproducibility of Results , Cross-Cultural Comparison , Urinary Bladder, Neurogenic/diagnosis , Urinary Bladder, Neurogenic/etiology , Spinal Cord Injuries/diagnosis , Spinal Cord Injuries/complications , Surveys and Questionnaires , Psychometrics
16.
Neurourol Urodyn ; 43(2): 464-478, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38196237

ABSTRACT

AIMS: To confirm the improved performance of the micro-hole zone catheter (MHZC) compared to a conventional eyelet catheter (CEC) in male users of clean intermittent catheterizations (CICs). METHODS: Male self-catheterizing subjects, who used hydrophilic sleeved soft/flexible CIC as the only bladder emptying method, were enrolled into a multi-center, randomized, cross-over study performed across six European sites. Subjects tested the MHZC, featuring a drainage zone with 120 micro-holes and a CEC with two eyelets. The study consisted of four study visits (V0-V3), during which endpoints related to catheter performance (urinary flow-stops, bladder emptying, and intra-catheter pressure) were measured and two 4-week test periods at home (T1 and T2) where dipstick hematuria and user perception between catheters were evaluated. RESULTS: Seventy-three male subjects with non-neurogenic and neurogenic bladder dysfunction (3:2) were enrolled. On average, catheterizations with the MHZC led to close to mean zero flow-stops compared to ≥1 flow-stops with the CEC, during both HCP- and self-led catheterizations (both p < 0.001). Residual urine at first flow-stop was significantly reduced for the MHZC compared to CEC (p = 0.001 and p = 0.004, for HCP- and self-led catheterizations, respectively). This was substantiated by a significantly smaller pressure peak at first flow-stop, a proxy for minimized mucosal suction (both HCP- and self-led catheterizations, p < 0.001). After home-use catheterizations, dipstick hematuria was comparable between catheters, whereas catheterizations were associated with significantly improved perception in favor of MHZC regarding bladder emptying, less blocking sensation, and improved hygienic catheterization compared to the CEC. CONCLUSION: This study confirmed the evidence of improved bladder emptying with the MHZC compared to a CEC without the need to reposition the catheter. The MHZC therefore offers an enhanced benefit for the dependent CIC user securing complete bladder emptying in an uninterrupted free flow and reducing the need to reposition the catheter during emptying.


Subject(s)
Intermittent Urethral Catheterization , Urinary Bladder, Neurogenic , Urinary Tract Infections , Adult , Humans , Male , Cross-Over Studies , Hematuria , Intermittent Urethral Catheterization/methods , Urinary Catheters , Urinary Catheterization/methods , Urinary Bladder, Neurogenic/etiology , Urinary Bladder, Neurogenic/therapy
17.
J Clin Neurosci ; 120: 87-91, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38237491

ABSTRACT

INTRODUCTION: Neurogenic bladder as well as fatigue related symptoms are common in patients with Multiple Sclerosis (MS) and have a significant impact on the patients' Quality of Life (QoL). The aim of this study is to investigate the relationship between fatigue related symptomatology (FRS) and Urinary Quality of Life (UQoL). METHODS: A total of 120 consecutive MS patients were recruited from the Outpatient Clinic of Demyelinating Diseases (Second Dept. of Neurology, Attikon University Hospital Greece). Participants were then asked to complete the Modified Fatigue Impact Scale (MFIS) and the Short Form Qualiveen questionnaire. Demographic and bladder function related characteristics (incontinence, urinary frequency, use of intermittent catheterization) were collected. RESULTS: The physical and cognitive dimensions of MFIS had a moderate to high correlation with SF Qualiveen (r = 0.403, p <.000), (r = 0.329, p <.000).Multiple linear regression produced a fitted model (R2 = 0.150, F(3,111) = 5.554, p =.001) in IC use (ß = 1.086, p =.036) and the physical dimension of MFIS (ß = 0.66, p =.046) significantly predicted the SF Qualiveen score. CONCLUSION: UQoL had a moderate correlation with both physical and cognitive dimensions of fatigue. Patients with MS who experience lower levels of physical fatigue and/or manage their neurogenic bladder symptomatology (mainly with the use of intermittent catheterization) appear to have higher levels of UQoL. Due to the versatile and subjective nature of both fatigue related and neurogenic bladder symptoms, more focused studies utilizing objective evaluation tools (e.g urodynamic urine bladder study) are necessary.


Subject(s)
Multiple Sclerosis , Urinary Bladder, Neurogenic , Humans , Quality of Life , Urinary Bladder, Neurogenic/etiology , Multiple Sclerosis/complications , Physical Examination , Fatigue/etiology , Surveys and Questionnaires
18.
Pediatr Nephrol ; 39(2): 409-421, 2024 Feb.
Article in English | MEDLINE | ID: mdl-37518419

ABSTRACT

Neurogenic bladder (NGB) is an encompassing term that includes multiple causes of bladder dysfunction linked to a congenital or acquired neurological condition that adversely impacts the innervation of the lower urinary tract. Multiple static or progressive conditions can be associated with NGB in pediatric and adolescent patients. Currently, spinal dysraphism (i.e., spina bifida) is one of the most common etiologies, which occurs in 3-4 per 10,000 live births in developed nations. Abnormal bladder dynamics can lead to kidney damage secondary to high pressures or recurrent infections, as well as urinary incontinence. The current management paradigm centers on a proactive approach to preserving kidney function and achieving continence through behavioral, pharmacological, and surgical means. This educational review highlights the key components of urological management to maximize collaboration with pediatric nephrologists.


Subject(s)
Spinal Dysraphism , Urinary Bladder, Neurogenic , Urinary Incontinence , Humans , Child , Adolescent , Urinary Bladder, Neurogenic/diagnosis , Urinary Bladder, Neurogenic/etiology , Urinary Bladder, Neurogenic/therapy , Nephrologists , Urinary Bladder , Spinal Dysraphism/complications , Spinal Dysraphism/therapy , Urodynamics
19.
J Spinal Cord Med ; 47(2): 300-305, 2024 Mar.
Article in English | MEDLINE | ID: mdl-36972202

ABSTRACT

OBJECTIVE: To investigate the association between multiple types of urological management and urological complications in patients with spinal cord injury (SCI). DESIGN: A retrospective cohort study. SETTING: Single medical center. METHODS: Medical records of SCI patients with regular follow-up of more than two years were reviewed. Urological management was classified into five groups: indwelling urethral catheter (IUC), clean intermittent catheterization (CIC), reflex voiding, suprapubic catheter (SPC), and self-voiding. We analyzed the incidence of urinary tract infection (UTI), epididymitis, hydronephrosis, and renal stone across the different urological-management groups. RESULTS: Of 207 individuals with SCI, the most common management type was self-voiding (n = 65, 31%) followed by CIC (n = 47, 23%). The IUC and SPC groups included more people with complete SCI than the other management groups. Compared with the IUC group, the SPC and self-voiding groups had lower risks of developing UTI (relative risk [RR] = 0.76, 95% CI, 0.59-0.97 and RR = 0.39, 95% CI, 0.28-0.55, respectively). The SPC group tended to have a lower risk of epididymitis than the IUC group (RR = 0.55, 95% CI, 0.18-1.63). CONCLUSION: Long-term IUC use was associated with a higher incidence of UTI in people with SCI. As compared to those with IUC, a lower risk of UTI was found in persons with SPC. These findings may have implications for shared clinical decision-making.


Subject(s)
Epididymitis , Spinal Cord Injuries , Urinary Bladder, Neurogenic , Male , Humans , Urinary Bladder, Neurogenic/epidemiology , Urinary Bladder, Neurogenic/etiology , Urinary Bladder, Neurogenic/therapy , Retrospective Studies , Spinal Cord Injuries/complications , Spinal Cord Injuries/epidemiology , Catheters, Indwelling/adverse effects
20.
Neurourol Urodyn ; 43(2): 459-463, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38078751

ABSTRACT

BACKGROUND: Clean intermittent self-catheterisation (CISC or ISC) is used by patients/carers to empty the bladder if needed. Sometimes the urethral lumen leading out of the bladder is blocked; sometimes, the bladder (detrusor) muscle itself or the autonomic motor nerves innervating the bladder are damaged, resulting in a failure of the detrusor muscle to work, leading to a failure of the bladder being able to empty adequately. Prior consensus as to the indications and timing of CISC has yet to be provided. This article aims to provide a multidisciplinary consensus view on this subject. CONCLUSION: It is evident that every patient needs to be considered individually, bearing in mind the symptoms and investigations to be considered. We emphasise the importance of considering the term Bladder Voiding Efficiency (BVE). One group of patients who might find CISC helpful are those with a neurological disorder; these include spinal injury patients, multiple sclerosis, Parkinson's, and a condition called cauda equina. Sometimes bladder problems are treated with anticholinergics, and others may be treated with Botox. These may cause the bladder not to empty at all, which is good for leaks but needs self-catheterisation to empty the bladder. In the past, hospitals used a permanent catheter called an 'indwelling' or a 'suprapubic' catheter. These can have side effects, including infections, stones, and pain. For CISC, disposable catheters are the best option for patients as they come in different sizes and styles to provide individualised care. In conclusion, we would like hospitals to consider each patient separately and not use a general 'one-size-fits-all' bladder function for these patients.


Subject(s)
Intermittent Urethral Catheterization , Urinary Bladder, Neurogenic , Humans , Urinary Catheterization/adverse effects , Intermittent Urethral Catheterization/adverse effects , Urinary Bladder, Neurogenic/etiology , Urinary Bladder, Neurogenic/therapy , Catheters , Pain/etiology
SELECTION OF CITATIONS
SEARCH DETAIL
...