Mohseni M.gh, Aghamir S.m.k, Meysame A, Gooran Sh, Mohtaram S.n,
Volume 65, Issue 10 (1-2008)
Abstract
Background: We evaluated the efficacy of botulinum-A toxin (BTX-A) injection into detrusor muscle in patients with incontinence resistant to anticholinergic drugs due to detrusor overactivity.
Methods: Our prospective study included 12 male patients with detrusor overactivity and incontinence due to spinal cord injury, which had been unsuccessfully treated with anticholinergic medication. Under visual control through the cystoscope 300 units of BTX-A were injected into detrusor muscle at 30 sites, sparing the trigone. After the treatment patients continued to perform clean intermittent self-catheterization (CIC) and clinical follow-up was planned for 6 weeks, 6 months and 9 months after treatment and urodynamic study was repeated after 6 weeks.
Results: At the 6-week follow-up complete continence was restored in 9 of the 12 patients and after 6 months of 9 continent patients 1 patient lost his follow-up from the study and 7 were still continent. After 9 months 3 patients remained continent. Mean cystometric bladder capacity (p<0.001), compliance (p<0.001), and mean post-void residual urine volume significantly increased (p<0.001), whereas maximal detrusor contraction pressure significantly decreased (p<0.001).
Conclusions: BTX-A injections appears to be an effective and safe therapeutic option for overactive bladder in adult patients with spinal cord injury failing anticholinergic therapy even if these patients present with very low bladder compliance. Patients may require repeated injections after 6 months to remain continent.
Shamsa Shariatpanahi , Soheila Khodakarim , Fateme Abolpour Mofrad,
Volume 72, Issue 9 (12-2014)
Abstract
Background: Chronic spinal cord injury has an important role in sensorimotor disor-ders which is associated with many complications and the rate of these complications should be certainly considered. The most important complications are the changes in bones and joints which come with pain and lead to increase in their motor disability. In this paper, the radiographic images were studied and the ossifications of spinal cord and pelvis were described and also the type of changes and their prevalence was eval-uated.
Methods: In this study, 500 patients and veterans with spinal cord injuries who were hospitalized in Khatam-Ol-Anbia Hospital were examined. The spinal and pelvis x-ray of the patients have been studied for spinal cord ossification, the hip joint narrowing, sacroiliitis, heterotopic ossification, osteophyte and the presence of quiver in the graph.
Results: Among the patients, 485 cases were males and 15 cases were females, the av-erage age was 50.26 and the mean duration of injury was 26 years. Four hundred and forty six patients were paraplegic and 54 cases were quadriplegic. There was a signifi-cant relationship between age and the number of involved vertebrae (P= 0.000), psori-asis like ossifications (P= 0.048) and large osteophytes (P= 0.037), also between the du-ration of the injury and the hip joint narrowing (P= 0.008), the number of involved ver-tebrae (P= 0.008). In addition the presence of shrapnel in the graph is correlated with large osteophytes and more heterotopic ossification.
Conclusion: The most frequent cause of chronic spinal injuries of our patients has been the injury by quiver, it seems our results may not be extended to all patients with spinal cord injury. In lumbar spine radiography of the patients, osteophytes, the quiver and psoriasis like ossifications were mostly seen. In the pelvis x-rays the most changes were hip joint narrowing, sacroiliitis and the heterotopic ossification.
