Clinical evaluation in 69 cases with neurogenic bladder
Sasagawa, M.; Magome, A.; Kikuyama, A.; Kobayashi, S.; Kawamura, K.; Suzuki, K.; Tsugawa, R.
Hinyokika Kiyo. Acta Urologica Japonica 37(2): 123-128
1991
ISSN/ISBN: 0018-1994 PMID: 1675545 Document Number: 387811
Clinical evaluation was made in 69 cases of neurogenic bladder experienced during the past 3 years. Thirty seven of the patients were male and 32 female, and they ranged in age from 4 to 88 years with an average of 63.2 years. The basic diseases of neurogenic bladder were brain lesion in 27 cases, spinal cord lesions in 18 cases, and peripheral nerve lesion in 13 cases. Three cases were of the mixed type and the basic disease was unknown in 8 cases. Cerebrovascular diseases were the most frequent, followed by spinal cord injuries and intrapelvic operations. Duration from the onset of urological symptoms to the first visit to our clinic was less than 1 month in half of the patients. The chief complaints at the first visit were pollakisuria in 25 cases (25.8%), incontinence in 18 cases (18.6%), urinary difficulty in 25 cases (25.8%) and urinary retention in 13 cases (13.4%). Urological conditions at the first visit were spontaneous urination in 53 cases (76.8%), indwelling catheterization in 12 cases (17.4%) and clean intermittent catheterization in 4 cases (5.8%). Urological complications seen at the first examination were urinary tract infections (UTI) in 27 cases (39.1%) and chronic renal failure in 2 cases (2.9%). The patients were classified by cystometrography into 3 patterns: 42 cases (60.9%) with underactive detrusor, 21 cases (30.4%) with overactive detrusor and 6 cases (8.7%) with normal detrusor. Detrusor sphincter dyssynergia was observed in 29 cases (42.0%), 40.7% had brain lesions, 44.4% spinal cord lesions, and 46.2% peripheral nerve lesions. The method of treatment was conservative in 90% of the cases and surgical in 10% of the cases. The rate of improving subjective symptoms by treatment with overactive detrusor was 85.7% and that with underactive detrusor was 64.3%. THe rate of improvement with UTI was 63%.