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F Castillo-Alcala, S Brown, T Crawshaw, R A Laven, G Riddle, I Lizarraga
CASE HISTORY: A group of 39, 19- to 22-month-old Friesian bulls were administered an ivermectin/closantel anthelmintic via intended S/C injection in the ischiorectal fossa on 15 June 2017 (Day 0). Over the next 50 days, 22 affected bulls presented various degrees of anorexia, abdominal pain and urine dribbling. Seventeen bulls were examined by transrectal ultrasonography which revealed urinary bladder distension in all 17, and peritoneal fluid accumulation in some. Overall, eight bulls died or were subjected to euthanasia...
February 11, 2019: New Zealand Veterinary Journal
Charlotte Andrianjafy, Laure Luciano, Camille Bazin, Karine Baumstarck, Michel Bouvier, Véronique Vitton
BACKGROUND: The aim of the study was to describe the results of 3D high-resolution anorectal manometry (3DHRAM) in a large cohort of patients with functional anorectal disorders. METHODS: In this single-center retrospective study, all consecutive patients referred for investigation of fecal incontinence (FI) or dyssynergic defecation (DD) underwent 3DHRAM. The parameters analyzed were usual manometric data, repartition of dyssynergic patterns, and the prevalence of a new "muscular subtype classification" underlying dyssynergia, anal sphincter defects, and pelvic floor disorders...
January 31, 2019: International Journal of Colorectal Disease
Prashant Singh, Yoonjin Seo, Sarah Ballou, Andrew Ludwig, William Hirsch, Vikram Rangan, Johanna Iturrino, Anthony Lembo, Judy W Nee
Background/Aims: Although symptoms related to the pelvic floor, such as pelvic organ prolapse (POP) and lower urinary tract symptoms (LUTS), are common in patients with chronic constipation (CC), its impact is not clear. Our aims were to investigate the following (1) compare pelvic floor symptom related dysfunction in irritable bowel syndrome with constipation (IBS-C) and functional constipation (FC), and (2) symptom correlation with findings on anorectal manometry (ARM) and balloon expulsion test...
January 31, 2019: Journal of Neurogastroenterology and Motility
Domenico Mascagni, Alessandra Panarese, Chiara Eberspacher, Gianmarco Grimaldi, Stefano Pontone, Salvatore Sorrenti, Daniele Pironi
BACKGROUND: The causes of obstructed defecation syndrome (ODS) can actually be either functional or mechanical (primary or secondary deficit of the sensitivity, slow bowel transit, pelvic floor dyssynergia, internal and external rectal prolapse, recto-anal intussusceptions, anterior or posterior rectocele and pelvic prolapse of the bladder, uterus, bowel or sigma). The aim of our study was evaluate the safety, efficacy and feasibility of Transanal Rectal Resection (STARR) procedure performed by a single or double stapler through clinical and functional outcomes for transanal stapled surgery...
January 4, 2019: Minerva Chirurgica
Lauren E Corona, Anne P Cameron, J Quentin Clemens, Yongmei Qin, John T Stoffel
PURPOSE: To describe a technique for urodynamic diagnosis of detrusor sphincter dyssynergia (DSD) using urethral pressure measurements and examine potential associations between urethral pressure and bladder physiology among patients with DSD. METHODS: Multiple sclerosis (MS) and spinal cord injured (SCI) patients with known DSD diagnosed on videourodynamics (via electromyography or voiding cystourethrography) were retrospectively identified. Data from SCI and MS patients with detrusor overactivity (DO) without DSD were abstracted as control group...
December 2018: International Neurourology Journal
Il Sup Kim, Young Il Kim, Jae Taek Hong, Dong Sup Lee
BACKGROUND: Detrusor sphincter dyssynergia (DSD), involuntary detrusor contractions (IDC) and poor bladder compliance (PC) are relatively common urodynamic findings in cervical myelopathy. However, there is little information regarding the role of a urodynamic study (UDS) after decompression surgery for cervical spondylotic myelopathy (CSM). METHODS: The urodynamic study was performed before and 6 months after decompression of CSM. The Japanese Orthopaedic Association (JOA) scores for cervical myelopathy and the Neck Disability Index (NDI) functional score were used...
December 21, 2018: World Neurosurgery
Paul M Cavallaro, Kyle Staller, Lieba R Savitt, Holly Milch, Kevin Kennedy, Milena M Weinstein, Rocco Ricciardi, Liliana G Bordeianou
BACKGROUND: Recently, there has been a trend toward surgical management of internal intussusception despite an unclear correlation with constipation symptoms. OBJECTIVE: This study characterizes constipation in patients with obstructed defecation syndrome and identifies whether internal intussusception or other diagnoses such as irritable bowel syndrome may be contributing to symptoms. DESIGN: Patients evaluated for obstructed defecation at a pelvic floor disorder center were studied from a prospectively maintained database...
January 2019: Diseases of the Colon and Rectum
Ryuji Sakakibara, Ayami Shimizu, Osamu Takahashi, Fuyuki Tateno, Masahiko Kishi, Yosuke Aiba, Hiroyoshi Suzuki, Tatsuya Yamamoto, Chiharu Shibata, Tomonori Yamanishi
In order to investigate lower urinary tract function in hereditary spastic paraplegia (HSP), we recruited 12 HSP patients: 8 men, 4 women; mean age, 64.6 years; mean disease duration, 18.9 years; walk without cane, 2, walk with cane, 6, wheelchair bound, 3. We performed urinary symptom questionnaires and a urodynamic testing in all patients. As a result, urinary symptoms were observed in all but 3, including urinary urgency/frequency (also called overactive bladder) in 9 and hesitancy/poor stream in 6. Urodynamic abnormalities included detrusor overactivity during bladder filling in 10, underactive detrusor on voiding in 8 (detrusor hyperactivity with impaired contraction [DHIC] in 5), detrusor-sphincter dyssynergia (DSD) on voiding in 3, and post-void residual in 5...
November 2, 2018: European Neurology
Chethan Ramprasad, Jane Yellowlees Douglas, Baharak Moshiree
Gastrointestinal disturbances are seen in nearly all patients with Parkinson's disease and lead to impaired quality of life, affect drug pharmacodynamics, and potentially worsen patient's existing motor fluctuations, leading to further disability. Recent evidence links abnormal accumulations of α-synuclein aggregates in the periphery (gut) as seen in the cortex which causes dysfunctions impacting every level of the gastrointestinal tract from the esophagus, to the stomach, small bowel, colon, and rectum and can even predate the onset of the central neurologic disorder itself...
December 2018: Current Treatment Options in Gastroenterology
Benoit Peyronnet, Xavier Gamé, Gregory Vurture, Victor W Nitti, Benjamin M Brucker
The use of botulinum toxin A (BTX-A) has revolutionized the treatment of neurogenic lower urinary tract dysfunction (NLUTD) over the past three decades. Initially, it was used as a sphincteric injection for detrusor sphincter dyssynergia but now is used mostly as intradetrusor injection to treat neurogenic detrusor overactivity (NDO). Its use is supported by high-level-of-evidence studies and it has become the gold-standard treatment for patients with NDO refractory to anticholinergics. Several novelties have emerged in the use of BTX-A in neurourology over the past few years...
2018: Reviews in Urology
Argyrios Stampas, Radha Korupolu, Liang Zhu, Christopher P Smith, Kenneth Gustafson
OBJECTIVES: We investigated whether transcutaneous tibial nerve stimulation (TTNS) in acute spinal cord injury was safe and feasible, and could achieve neuromodulation and improve cystometrogram parameters during acute inpatient rehabilitation. MATERIALS AND METHODS: Participants were consecutive acute traumatic spinal cord injury patients admitted for acute inpatient rehabilitation, randomized to a 2-week trial of TTNS v sham stimulation. Primary outcomes were safety and feasibility of TTNS and secondary outcomes were bladder measures based on pre- and post-TTNS cystometrogram by group and within groups, including bladder capacity, detrusor hyperreflexia, pressures, and detrusor-sphincter dyssynergia, as well as filling sensations and desire to void...
October 3, 2018: Neuromodulation: Journal of the International Neuromodulation Society
M S Fernández Córdoba, C Parrondo Muiños, Y M Argumosa Salazar, V Marijuán Sahuquillo, M Ramírez Piqueras, T Moratalla Jareño, J Rojas Ticona, A Vidal Company
OBJECTIVES: To assess the utility of a new modality of video-urodynamic for study of lower urinary tract dysfunction and other uropathies in kids, replacing voiding cystourethrography by echo-enhanced cystosonography, without ionizing radiations. MATERIAL AND METHODS: Prospective study with simultaneous performance of filling cystometry and cystosonography in 43 kids during the last two years. The sonographic contrast was infused trough the urodynamic catheter. RESULTS: 18 girls and 25 boys, with an average age of 6...
August 3, 2018: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
Satish S C Rao, Jessica A Valestin, Xuelian Xiang, Shaheen Hamdy, Catherine S Bradley, M Bridget Zimmerman
BACKGROUND: Office-based biofeedback therapy is effective for constipation with dyssynergic defecation, but must be performed by skilled staff, is only available in selected centres, and requires multiple visits. The efficacy of home-based biofeedback therapy is unknown. We compared clinical and subjective outcomes with home-based and office-based approaches. METHODS: In this randomised controlled trial, eligible patients were adult outpatients (age 18-80 years) who met the Rome III criteria for functional constipation and who had been referred to a tertiary-care centre after non-response to routine management, and who had dyssynergic defecation...
November 2018: Lancet. Gastroenterology & Hepatology
Diana V Hunter, Seth D Holland, Matt S Ramer
Spinal cord injury (SCI) disconnects supraspinal micturition centers from the lower urinary tract resulting in immediate and long-term changes in bladder structure and function. While cervical and high thoracic SCI have a greater range of systemic effects, clinical data suggest that those with lower (suprasacral) injuries develop poorer bladder outcomes. Here we assess the impact of SCI level on acute changes in bladder activity. We used two SCI models, T3 and L2 complete transections in male Wistar rats, and compared bladder pressure fluctuations to those of naïve and bladder-denervated animals...
2018: Frontiers in Physiology
Lauren Folgosa Cooley, Stephanie Kielb
Prior to FDA approval of intradetrusor botulinum toxin (BoTA) injections for the treatment of neurogenic bladder, patients had limited treatment options including "off-label" use of pharmacotherapies (anticholinergics, beta agonists, and alpha-blockers) or invasive interventions including bladder augmentation and urinary diversion procedures. Herein, we provide a comprehensive literature review detailing the salient clinical literature that led to FDA approval of intradetrusor BoTA for neurogenic bladder...
August 21, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
Tianyi Niu, Carol J Bennett, Tina L Keller, J C Leiter, Daniel C Lu
Patients with chronic spinal cord injury (SCI) cannot urinate at will and must empty the bladder by self-catheterization. We tested the hypothesis that non-invasive, transcutaneous magnetic spinal cord stimulation (TMSCS) would improve bladder function in individuals with SCI. Five individuals with American Spinal Injury Association Impairment Scale A/B, chronic SCI and detrusor sphincter dyssynergia enrolled in this prospective, interventional study. After a two-week assessment to determine effective stimulation characteristics, each patient received sixteen weekly TMSCS treatments and then received "sham" weekly stimulation for six weeks while bladder function was monitored...
August 22, 2018: Scientific Reports
Subhankar Chakraborty, Kelly Feuerhak, Anjani Muthyala, William S Harmsen, Kent R Bailey, Adil E Bharucha
BACKGROUND & AIMS: Some patients with defecatory disorders (DD) have high anal pressures that may impede rectal evacuation. Alpha-1 adrenoreceptors mediate as much as 50% of anal resting pressure in humans. We performed a randomized, placebo-controlled study of the effects of alfuzosin, an alpha1-adrenergic receptor antagonist, on anal pressures alone in healthy women and also on bowel symptoms in women with DD. METHODS: In a double-blind study performed from March 2013 through March 2017, anal pressures were evaluated before and after 36 women with DD (constipation for at least 1 year) and 36 healthy women (controls) were randomly assigned (1:1) to groups given oral alfuzosin (2...
August 18, 2018: Clinical Gastroenterology and Hepatology
Ricardo Guilherme Viebig, Janaina Tomiye Yamakata Franco, Sergio Viebig Araujo, Daniel Gualberto
BACKGROUND: High resolution anorectal manometry (HRAM-WP) allows more simplified, objective, and uniform data acquisition and interpretation of the test results. OBJECTIVE: To validate a HRAM under water perfusion (Alacer Biomédica) with a 24-channel probe and to compare the results of anorectal manometry with other systems. METHODS: Individuals without critical evacuation disorders were selected. Patients with incontinence, anal surgery, dyssynergia or sphincter injury were excluded...
August 6, 2018: Arquivos de Gastroenterologia
Parag N Gad, Evgeniy Kreydin, Hui Zhong, Kyle Latack, V Reggie Edgerton
It is commonly assumed that restoration of locomotion is the ultimate goal after spinal cord injury (SCI). However, lower urinary tract (LUT) dysfunction is universal among SCI patients and significantly impacts their health and quality of life. Micturition is a neurologically complex behavior that depends on intact sensory and motor innervation. SCI disrupts both motor and sensory function and leads to marked abnormalities in urine storage and emptying. Current therapies for LUT dysfunction after SCI focus on preventing complications and managing symptoms rather than restoring function...
2018: Frontiers in Neuroscience
Jia-Fong Jhang, Hann-Chorng Kuo
OnabotulinumtoxinA (BoNT-A) was first used to treat neurogenic lower urinary tract dysfunction (LUTD) 30 years ago. Recently, application of BoNT-A in LUTD have become more common since the approval of intravesical BoNT-A injection for patients with both overactive bladders (OAB) and neurogenic detrusor overactivity (NDO) by regulatory agencies in many countries. Although unlicensed, BoNT-A has been recommended to treat patients with interstitial cystitis/bladder pain syndrome (IC/BPS) under different guidelines...
June 26, 2018: Toxins
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