20 research outputs found
Treatment of neurogenic detrusor overactivity using botulinum toxin A
2. Summary Treatment of neurogenic detrusor overactivity using botulinum toxin A Introduction: The treatment of neurogenic detrusor overactivity (NDO) is still a serious medical, social and economic problem. Using onabotulinumtoxinA (onaBTA) is the first choice in patients who are refractory to standard anticholinergic therapy or with the occurrence of serious adverse events from this treatment. The standard way of applying onaBTA is intramural injection into the detrusor of the urinary bladder. Aim: To evaluate the effectiveness of the NDO treatment with submucosal applications of onaBTA with regard to the complex mechanism of the action of onaBTA on the urinary bladder. Methods: A randomized, prospective open-label study was performed. The study population consisted of patients with neurogenic detrusor overactivity due to spinal cord injury. A total of 23 patients, in which urinary incontinence persisted due to NDO despite anticholinergic therapy, were included. After randomization, patients were treated with 300 U onaBTA applied in 30 injection sites, sparing bladder trigone. In group A the treatment was carried out using submucosal applications and in group B with intramural application into the detrusor. The length of the study was 12 weeks. Urodynamic examination was performed before and after the..
SpontánnĂ ruptura moÄŤovĂ©ho mÄ›chýře: dva pĹ™Ăpady z našeho pracovištÄ›
HlavnĂ stanovisko práce: prezentujeme kazu‑istiku dvou vzácnĂ˝ch pĹ™ĂpadĹŻ spontánnĂ ruptury moÄŤovĂ©ho mÄ›chýře z našeho pracovištÄ› se za‑měřenĂm na diagnostická ĂşskalĂ a terapeutickĂ˝ postup.Perforace moÄŤovĂ©ho mÄ›chýře je zpĹŻsobena nejÄŤastÄ›ji tupĂ˝m, nebo penetrujĂcĂm poranÄ›nĂm, popĹ™ĂpadÄ› iatrogennÄ›. SpontánnĂ ruptura moÄŤo‑vĂ©ho mÄ›chýře je velice vzácná. Vzhledem k mini‑málnĂ frekvenci vĂ˝skytu bĂ˝vá tato moĹľnost v rámci diferenciálnĂ diagnostiky opomĂjena. V literatuĹ™e je jejĂ vĂ˝skyt ÄŤasto uvádÄ›n v souvislosti s chronickĂ˝m abĂşzem alkoholu. KlĂÄŤovou roli v diagnostice hraje klinickĂ˝ obraz, zobrazovacĂ metody a laboratornĂ vyšetĹ™enĂ. V našà práci prezentujeme dva pĹ™Ăpady spontánnĂ ruptury moÄŤovĂ©ho mÄ›chýře na našem pracovišti v prĹŻbÄ›hu roku 2015. V lĂ©ÄŤbÄ› je metodou volby chirurgickĂ© ošetĹ™enĂ.Major statement: we present two rare cases of spontaneous bladder rupture treated in our departement focusing on diagnosing troubles and therapeutic procedures.Perforation of the urinary bladder is, in most cases, caused by blunt or penetrative trauma, oc‑casionally by iatrogenic trauma. A spontaneous rupture of the urinary bladder is very rare. Due to the rare occurrence this possibility is often omit‑ted in the differential diagnosis. In the literature, its
81Ces Urol 2017; 21(1): 80–84KAZUISTIKArelation with chronic alcohol abuse is quoted. Key to diagnosis are clinical investigations, laboratory investigations and imaging methods. The authors present two cases of spontaneous rupture of the urinary bladder treated in 2015. The treatment of choice is surgical repair