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Bladder-pumping therapy for the treatment of low-capacity or low-compliance bladders

2000; Wiley; Volume: 19; Issue: 1 Linguagem: Inglês

10.1002/(sici)1520-6777(2000)19

1520-6777

Kimio Sugaya, Osamu Nishizawa, Tomoya Satoh, Tadashi Hatano, Yoshihide Ogawa,

Urological Disorders and Treatments

The walls of low-capacity or low-compliance bladders are thought to be less elastic than normal. Pumping of the bladder was found to disrupt collagen-fiber bundles in the rat bladder wall, offering the promise of potential clinical application. This result prompted us to use bladder-pumping therapy to soften the bladder wall in patients with low-capacity or low-compliance bladders to restore bladder elasticity. CO2 gas or air, at a volume below the maximum bladder capacity (≤200 mL), was repeatedly pumped in and out of the bladder through a catheter under caudal anesthesia in 26 patients with low-capacity or low-compliance bladders and without uninhibited bladder contractions, who presented with urinary frequency or incontinence. A respirator was used to control the pumping at 0.5 cycles/s for a duration of 15 minutes. No serious adverse effects were encountered during or after the procedure. Overall subjective improvement was noted 4 weeks after the procedure in 11 of 18 patients with a low capacity bladder (<300 mL) and in five of eight patients with a low-compliance bladder (<20 mL/cm H2O). The procedure significantly increased the maximum bladder capacity, single voided volume, and average urinary flow rate after 4 weeks. In the responding patients, subjective improvement lasted from 3 months to over 6 years. Bladder-pumping therapy is an easy and safe procedure and exerts a beneficial effect for a long period, in patients with low-capacity or low-compliance bladders and without uninhibited bladder contractions. Neurourol. Urodynam. 19:19–28, 2000. © 2000 Wiley-Liss, Inc.