Neurogenic Bladder Flashcards
What is Hinman’s Syndrome
non-neurogenic neurogenic bladder or dysfunctional voiding in the absence of a neurologic condition
UDS may show bladder dyssenergy between bladder contraction and sphincter contraction
What are the FDA indications for Interstim
non-obstructive urinary retention, urinary urge incontinence, urinary urgency-frequency syndrome, chronic fecal incontinence
What are the results of the VALUE trial?
Urodynamics is no more useful then basic exam for uncomplicated stress urinary incontinence
Compared to retropubic sling, transobturator slings are more likely to experience
Neurologic complications (from obturator pudendal nerve branch)
What is pseudodysenergia?
voluntary contraction of sphincter during uninhibited bladder contraction
what were the outcomes of the Rosetta trial?
Neuromodulation vs. botox
No difference in mean urgency
Better satisfaction w/ treatment in the botox arm
Botox had more UTI and need for CIC
What is the most common bladder dysfunction problems in patients with spina bifida or tethered cord?
Detrusor overactivity
what lesions result in detrusor smooth and striated sphincter dyssenergia?
Lesions in the spinal cord above the lower thoracic level of the sympathetic outflow (> T6)
What are the hemodynamics in autonomic dysreflexia (hyperreflexia)?
How do you treat?
Hypertension and reflex bradycardia.
Ensure bladder drainage.
what is considered an abnormal bladder compliance?
< 10-20 ml/cm H2O
what lesions result in striated sphincter dyssenergia only?
T6 - S2
What injuries are at risk for autonomic dysreflexia?
> /= T6 spinal level
Where does the sacral spinal level begin?
Vertebral level T12-L1
What happens in spinal shock?
Areflexic Bladder Closed/competent bladder neck Internal and External sphincter synergy No guard reflex Loss of voluntary control
