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Effects of Acute Bolus and Chronic Continuous Intrathecal Baclofen on Genitourinary Dysfunction Due to Spinal Cord Pathology

1992; Lippincott Williams & Wilkins; Volume: 148; Issue: 6 Linguagem: Inglês

10.1016/s0022-5347(17)37048-9

1527-3792

William D. Steers, Jay M. Meythaler, Charles Haworth, Duke Herrell, T.S. Park,

Pediatric Pain Management Techniques

No AccessJournal of Urology1 Dec 1992Effects of Acute Bolus and Chronic Continuous Intrathecal Baclofen on Genitourinary Dysfunction Due to Spinal Cord Pathology William D. Steers, Jay M. Meythaler, Charles Haworth, Duke Herrell, and T.S. Park William D. SteersWilliam D. Steers , Jay M. MeythalerJay M. Meythaler , Charles HaworthCharles Haworth , Duke HerrellDuke Herrell , and T.S. ParkT.S. Park View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)37048-9AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail A prospective, blinded study was done to examine the effects of acute bolus and chronic continuous intrathecal baclofen on genitourinary function in 10 patients with severe spasticity due to spinal cord pathology. Genitourinary function was assessed by symptom questionnaires and urodynamic studies performed after a bolus dose of baclofen and 6 to 12 months after continuous intrathecal baclofen. Results were compared to placebo for acute bolus testing or to pre-continuous intrathecal baclofen values. In all patients with irritative voiding and urge incontinence uninhibited bladder contractions were eliminated. Of 3 patients with an indwelling urethral catheter for incontinence due to detrusor hyperreflexia 1 was converted to intermittent self-catheterization. Whereas bladder capacity, compliance, sensation and voiding pressures were not different after continuous intrathecal baclofen, when a mean of all patients was compiled, a 72% increase in capacity and 16% improvement in compliance were observed in subjects without cervical spinal cord pathology. Detrusor-sphincter dyssynergia was abolished in 40% of the patients. Continuous intrathecal baclofen may represent a novel approach to the management of patients with a neurogenic bladder who have decreased bladder compliance and detrusor hyperreflexia not controlled by oral medications. © 1992 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByMiyazato M, Sugaya K, Saito S, Chancellor M, Goins W, Goss J, de Groat W, Glorioso J and Yoshimura N (2018) Suppression of Detrusor-Sphincter Dyssynergia by Herpes Simplex Virus Vector Mediated Gene Delivery of Glutamic Acid Decarboxylase in Spinal Cord Injured RatsJournal of Urology, VOL. 184, NO. 3, (1204-1210), Online publication date: 1-Sep-2010.Miyazato M, Sasatomi K, Hiragata S, Sugaya K, Chancellor M, de Groat W and Yoshimura N (2018) GABA Receptor Activation in the Lumbosacral Spinal Cord Decreases Detrusor Overactivity in Spinal Cord Injured RatsJournal of Urology, VOL. 179, NO. 3, (1178-1183), Online publication date: 1-Mar-2008.MIYAZATO M, SUGAYA K, NISHIJIMA S, ASHITOMI K, MOROZUMI M and OGAWA Y (2018) DIETARY GLYCINE INHIBITS BLADDER ACTIVITY IN NORMAL RATS AND RATS WITH SPINAL CORD INJURYJournal of Urology, VOL. 173, NO. 1, (314-317), Online publication date: 1-Jan-2005.CHANCELLOR M, GAJEWSKI J, DOUGLAS ACKMAN C, APPELL R, BENNETT J, BINARD J, BOONE T, CHETNER M, CREWALK J, DEFALCO A, FOOTE J, GREEN B, JUMA S, JUNG S, LINSENMEYER T, MacMILLAN R, MAYO M, OZAWA H, ROEHRBORN C, SHENOT P, STONE A, VAZQUEZ A, KILLORIN W and RIVAS D (2018) LONG-TERM FOLLOWUP OF THE NORTH AMERICAN MULTICENTER UROLUME* TRIAL FOR THE TREATMENT OF EXTERNAL DETRUSOR-SPHINCTER DYSSYNERGIAJournal of Urology, VOL. 161, NO. 5, (1545-1550), Online publication date: 1-May-1999.Watanabe T, Perkash I and Constantinou C (2018) Modulation of Detrusor Contraction Strength and Micturition Characteristics by Intrathecal Baclofen in Anesthetized RatsJournal of Urology, VOL. 157, NO. 6, (2361-2365), Online publication date: 1-Jun-1997.Chancellor M, Rivas D, Linsenmeyer T, Abdill C, Ackman C, Appell R, Bennett J, Binard J, Boone T, Chetner M, Defalco A, Foote J, Gajewski J, Green B, Juma S, MacMillan R, Mayo M, Roehrborn C, Stone A, Thorndyke W and Vazquez A (2018) Multicenter Trial in North America of Urolume Urinary Sphincter ProsthesisJournal of Urology, VOL. 152, NO. 3, (924-930), Online publication date: 1-Sep-1994. Volume 148Issue 6December 1992Page: 1849-1855 Advertisement Copyright & Permissions© 1992 by The American Urological Association Education and Research, Inc.Keywordsmuscle spasticityurination disordersbaclofenspinal cord injuriesparaplegiaMetricsAuthor Information William D. Steers More articles by this author Jay M. Meythaler More articles by this author Charles Haworth Current address: 8901 Wisconsin Ave., NNMC-Bethesda Naval Hospital, Bethesda, Maryland 20814. More articles by this author Duke Herrell More articles by this author T.S. Park Current address: Department of Neurosurgery, St. Louis Children's Hospital, Washington University School of Medicine, 400 S. Kingshighway Blvd., St. Louis, Missouri 63110. More articles by this author Expand All Advertisement PDF DownloadLoading ...