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PEER-TO-PEER CLINICAL CONVERSATIONS |
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Autonomic Dysreflexia: Managing a Complex Patient - Part 1
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Todd Linsenmeyer, MD
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| Diane Newman hosts Todd Linsenmeyer to discuss the management of autonomic dysreflexia. Dr. Linsenmeyer, an authority on autonomic dysreflexia management, especially post-spinal cord injuries, discusses the condition's diagnosis and treatment.
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Types of Neurogenic Bladder Disorders
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Diane K. Newman, DNP, ANP-BC, BCB-PMD, FAAN
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| Diane Newman, an adult nurse practitioner and a continence nurse specialist in urology outlines four types of neurogenic bladder disorders: atonic bladder, hyper-reflexive bladder, uninhibited bladder, and sensorimotor paralytic bladder. In addition to describing their symptoms, she also advises on how to diagnose and treat these disorders.
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| Incidence of Urinary Tract Infections Between Neurogenic and Non-Neurogenic Bladder Dysfunction Patients Performing Intermittent Catheterization - An Analysis of Marketscan Data
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| Blayne Welk, MD, FRCSC, MSC, Sara Lenherr, MD, Yasir Santiago-Lastra, MD, Melanie Goodman Keiser, Ph.D., Holly Norman, Ph.D., Christopher Elliott, MD, Ph.D.
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| This study compares UTI incidence and severity among intermittent catheter (IC) users with neurogenic (NLUTD) and non-neurogenic diagnoses. An analysis of health insurance claims data from the IBM MarketScan Database (commercial Preferred-Provider Organization and Medicare supplemental claims) between January 1, 2015 – December 31, 2019, was presented.
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| Happy Bladder, Better Life: A Safe and Efficacious Way to Treat Bladder-Related Autonomic Dysreflexia in Individuals with Spinal Cord Injury - Beyond the Abstract
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| Stephanie Kran, MD, Resident; Matthias Walter, MD, Ph.D., FEBU, and Andrei V. Krassioukov, MD, Ph.D., FRCPC
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| Spinal cord injuries often lead to neurogenic lower urinary tract dysfunction (NLUTD), which can include neurogenic detrusor overactivity and episodes of autonomic dysreflexia. The study discusses the benefits of using intradetrusor onabotulinumtoxinA injections as a safe and effective treatment option to alleviate autonomic dysreflexia in individuals with spinal cord injury.
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| OnabotulinumtoxinA Ameliorates Autonomic Dysreflexia While Improving Lower Urinary Tract Function and Quality of Life in Individuals with Spinal Cord Injury
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| Matthias Walter, MD
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| This study aimed to evaluate the efficacy of onabotulinumtoxinA in reducing autonomic dysreflexia (AD) in individuals with spinal cord injuries (SCI) while improving their quality of life. The study found that onabotulinumtoxinA not only improved lower urinary tract function but also decreased the severity and frequency of AD in daily life and during urodynamic investigations.
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| Botulinum Toxin A in the Treatment of Neurogenic Bladder- Beyond the Abstract
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| Lauren Folgosa Cooley, MD, Ph.D., Stephanie Kielb, MD
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| The introduction of intravesical botulinum toxin A (BoTA) has significantly improved the treatment options for patients with neurogenic bladder. This treatment provides advantages such as ease of administration, safety, patient compliance, cost-effectiveness, and durable efficacy, ultimately leading to improvements in continence, bladder mechanics, and quality of life. The aim of this review is to share the indications, technique, and efficacy of intravesical BoTA with other specialists, particularly physiatrists, who manage patients with neurogenic bladder.
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| Management of Sphincter Insufficiency in Patients with Neurogenic Bladder and Bladder Augmentation - Beyond the Abstract
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| Niklas Pakkasjärvi, MD & Taskinen Seppo, MD
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| In pediatric patients with neurogenic bladder, preserving renal function is achievable when guided by urodynamic investigations. However, urinary incontinence remains a challenge and can result from various factors such as bladder size, pressure, sphincter function, or patient adherence issues. This study aimed to explore the need and effectiveness of bladder neck procedures (BNPs) in patients with neurogenic bladder who had undergone bladder augmentation.
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