Neurogenic Bladder And Bowel Dysfunction

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Neurogenic Bladder And Bowel Dysfunction

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Author : Peter Wide
language : sv
Publisher: Linköping University Electronic Press
Release Date : 2020-09-11

Neurogenic Bladder And Bowel Dysfunction written by Peter Wide and has been published by Linköping University Electronic Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2020-09-11 with categories.

Spinal dysraphism (SD) is a congenital malformation that to a varying extent, often severely, affects the life of the child and the family. Most individuals with SD suffer from neurogenic bladder and bowel dysfunction—with the risk of urinary tract infections, renal deterioration, urinary and fecal incontinence—that affects social participation and quality of life negatively. In newborns with SD, early detection of neurogenic bladder dysfunction and determination of post-void residual urine are required to determine the need of clean intermittent catheterization (CIC) and follow-up. The non-invasive method of four-hour voiding observation with provocation test (VOP) was used to evaluate bladder function in 50 newborn children with SD. Voiding patterns for the children were described and compared with those of 50 healthy newborns evaluated with VOP in an earlier study. Comparison revealed significant differences among several variables. In particular, leakage at provocation test and not voiding with a stream were common in newborns with SD but did not occur in healthy newborns. VOP is a non-invasive standardized method to determine residual urine in newborns with SD. It also adds information on voiding pattern, frequency, voiding with a stream and leakage at provocation. Findings in neonatal VOP of the same cohort of newborns with SD were then related to radiology, presence of urinary tract infections during the first year, and urodynamic findings and use of CIC at the age of one year. It was found that, in children with SD, not voiding with a stream may have a predictive value for the need of CIC at the age of one year, followed probably by lifelong CIC. Despite this, the presence of an open SD per se has stronger predictive value, and each child needs to be evaluated individually while considering a number of factors. The main value of VOP may be as a structured non-invasive screening method to uncover neurogenic bladder-sphincter dysfunction in the newborn. Studies with a larger number of subjects than the present are needed to evaluate the potential of VOP in newborns with closed spinal dysraphism in whom the neurological consequences vary. A retrospective analysis detected renal damage on DMSA scintigraphy in 5 of 41 children with SD who were followed according to a proactive national program with minimal use of surgery. Median follow-up time was 10 years. High baseline pressure was confirmed as a risk factor for renal damage. Compliance with treatment and follow-up is likely to be an important factor for renal health. Therefore, efforts to support children and their families are crucial. A questionnaire-based study of 107 children with SD (age 6–16y) in Sweden and Norway examined aspects of treatment for neurogenic bowel dysfunction focusing on incontinence, independence, general satisfaction and quality of life. It was found that transanal irrigation (TAI) and antegrade colonic enemas (ACE) are effective treatments, but are time-consuming and difficult to perform independently. The majority of children using TAI (72%) and ACE (63%) never went to the toilet alone to empty their bowels. As children achieving independence on the toilet reported higher quality of life, efforts to support independence are beneficial. Continent, self-managing children with healthy kidneys enjoy high quality of life and contribute more fully to society. Therefore, further research is required to investigate and develop existing and new technologies and methods that mitigate the problems related to SD, and to make them accessible to all children with spinal dysraphism. Under de senaste 50 åren har det skett en enastående utveckling av möjligheterna för barn som föds med ryggmärgsbråck. Tidigare har majoriteten av barn med ryggmärgsbråck avlidit redan som spädbarn men idag överlever de flesta till vuxen ålder. Utan aktiva insatser och uppföljning är dock risken för medicinska problem och allvarlig påverkan på livet mycket stor. Nu när nästan alla barn överlever ligger fokus på att också nå okad livskvalitet och självständighet för personer med ryggmärgsbråck. Nästan alla med ryggmärgsbråck måste hantera en allvarlig påverkan på blåsan och tarmen med risk för njurskador, inkontinens och förstoppning. I avhandlingens två första studier värderade vi en metod att, med minimalt obehag för barnet, bedöma blåsfunktionen. Detta för att kunna skilja ut de barn som behöver genomgå mer avancerade undersökningar och få hjälp med blåstömningen genom täta tappningar med kateter, sa kallad ren intermittent kateterisering, RIK. När vi jämförde resultatet av testet för 50 nyfödda med ryggmärgsbråck med samma undersökning av 50 friska nyfödda fann vi stora skillnader. Mest tydligt var att de flesta nyfödda med ryggmärgsbråck (69%) men inga friska nyfödda läckte urin när man tryckte över blåsan. Av nyfödda med ryggmärgsbråck kissade de flesta (74%) inte med stråle vilket alla friska nyfödda gjorde. Att inte kissa med stråle talade också starkt för att barnet skulle komma att behöva hjälp med RIK för att tomma blåsan vid ett ars ålder, och då sannolikt livet ut. Sammantaget visade avhandlingens två första arbeten att den metod för bedömning av blåsfunktion vi undersökt kan användas för att styra uppföljning och behandling av nyfödda med ryggmärgsbråck. Avhandlingens tredje studie visade att aktiv uppföljning av barnen enligt ett nationellt vårdprogram lyckades förhindra njurskador hos de flesta, men att höga tryck i urinblåsan och återkommande urinvägsinfektioner ökade risken för skador. Även familjernas förmåga att i en pressad vardag klara av att genomföra de ofta krävande behandlingar och undersökningar som rekommenderas verkade vara viktig för att förhindra njurskador. Stöttning av familjerna är därför viktig. Avhandlingens fjärde arbete berörde tarmen som nästan alltid är påverkad vid ryggmärgsbråck, med risk för svår förstoppning och avföringsläckage. Detta har påtaglig påverkan på barnen och deras familjer. En tredjedel av de 107 familjerna i vår enkätundersökning i Sverige och Norge (barn 6-16 år) beskrev att man fått avstå från aktiviteter såsom resor på grund av barnets tarmproblem och de barn som hade avföringsläckage rapporterade tydligt lägre livskvalitet än andra. Trots denna allvarliga påverkan finns det hittills inga studier som jämför de olika behandlingar som barnet kan använda. I vår enkät kartlade vi därför vilka metoder som användes och hur bra de fungerade. Vi ställde frågor till både barn och föräldrar, särskilt om avföringsläckage, hur nöjd man var med metoden, barnens livskvalitet och självständighet på toaletten. Det var utifrån svaren tydligt att båda de vanligaste typerna av tarmsköljning var effektiva men tidskrävande och svara för barn och ungdomar att klara att utföra på egen hand. Ingen metod visade sig överlägsen den andra men de barn som klarade att skota tarmtomningen själva skattade sin livskvalitet klart högre än övriga. Vi drar därför slutsatsen att det är viktigt att vårdpersonal diskuterar de olika behandlingsalternativen med barn och föräldrar, och tillsammans med dem väljer den metod som passar det enskilda barnet bäst. Då skapas bästa förutsättningar för att gemensamt arbeta vidare för att uppnå största möjliga självständighet. Självständiga individer, med friska njurar och utan urin- och avföringsinkontinens upplever högre livskvalitet och behöver mindre sjukvård och andra samhällsinsatser. Det behövs mer forskning för att utveckla existerande och nya metoder att hantera de allvarliga komplikationer som riskerar att drabba barn och vuxna med ryggmärgsbråck.

Imaging Acute Neurologic Disease

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Author : Massimo Filippi
language : en
Publisher: Cambridge University Press
Release Date : 2014-09-11

Imaging Acute Neurologic Disease written by Massimo Filippi and has been published by Cambridge University Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2014-09-11 with Medical categories.

A comprehensive survey of best practice in using diagnostic imaging in acute neurologic conditions. The symptom-based approach guides the choice of the available imaging tools for efficient, accurate, and cost-effective diagnosis. Effective examination algorithms integrate neurological and imaging concepts with the practical demands and constraints of emergency care.

Neurourology

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Author : Limin Liao
language : en
Publisher: Springer
Release Date : 2019-04-18

Neurourology written by Limin Liao and has been published by Springer this book supported file pdf, txt, epub, kindle and other format this book has been release on 2019-04-18 with Medical categories.

This book introduce neurourology as an emerging interdisciplinary area that covers the basic and clinical studies of the neural control on the normal lower urinary tract and the lower/upper urinary tract dysfunction due to neuropathy disorders. It systematically describes all aspects of neurourology from the epidemiology of the neurogenic bladder; to the pathology and pathophysiology of the lower urinary tract; to the diagnosis and treatment of the neurogenic bladder by conservative therapies or surgeries. This book provides a useful resource for medical doctors, nurses and students in the field of neurourological conditions. All the topics are written by internationally recognized specialists in their field.

Neurorehabilitation Therapy And Therapeutics

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Author : Krishnan Padmakumari Sivaraman Nair
language : en
Publisher: Cambridge University Press
Release Date : 2018-10-11

Neurorehabilitation Therapy And Therapeutics written by Krishnan Padmakumari Sivaraman Nair and has been published by Cambridge University Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2018-10-11 with Medical categories.

This practical handbook for clinicians covers pharmacological and non-pharmacological treatment options in neurological rehabilitation.

Essentials Of Pediatric Urology

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Author : Duncan T Wilcox
language : en
Publisher: CRC Press
Release Date : 2021-12-05

Essentials Of Pediatric Urology written by Duncan T Wilcox and has been published by CRC Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2021-12-05 with Medical categories.

Essentials of Pediatric Urology provides surgical trainees with an up to date and comprehensive account of the urological disorders of childhood . In addition, this popular textbook makes a valuable practical contribution to clinical decision making by Adult Urologists and General Pediatric Surgeons who treat conditions of the genitourinary systems in children. This established resource fulfils a unique role as the only international textbook of Pediatric Urology written primarily for trainees and those practising adult Urology, Pediatric Surgery, and Pediatric Urology. The third edition continues to meet this need as well as providing a ready source of reference for non-specialists including Pediatricians and Nurses.

Neurologic Differential Diagnosis

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Author : Alan B. Ettinger
language : en
Publisher: Cambridge University Press
Release Date : 2014-04-17

Neurologic Differential Diagnosis written by Alan B. Ettinger and has been published by Cambridge University Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2014-04-17 with Medical categories.

Unique case-based guide to generating diagnostic possibilities based on the patients' symptoms. Invaluable for psychiatrists and neurologists.

Spinal Cord Medicine

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Author : Denise I. Campagnolo
language : en
Publisher: Lippincott Williams & Wilkins
Release Date : 2011-12-07

Spinal Cord Medicine written by Denise I. Campagnolo and has been published by Lippincott Williams & Wilkins this book supported file pdf, txt, epub, kindle and other format this book has been release on 2011-12-07 with Medical categories.

This comprehensive and practical reference is the perfect resource for the medical specialist treating persons with spinal cord injuries. The book provides detail about all aspects of spinal cord injury and disease. The initial seven chapters present the history, anatomy, imaging, epidemiology, and general acute management of spinal cord injury. The next eleven chapters deal with medical aspects of spinal cord damage, such as pulmonary management and the neurogenic bladder. Chapters on rehabilitation are followed by nine chapters dealing with diseases that cause non-traumatic spinal cord injury. A comprehensive imaging chapter is included with 30 figures which provide the reader with an excellent resource to understand the complex issues of imaging the spine and spinal cord.

Textbook Of The Neurogenic Bladder

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Author : Jacques Corcos
language : en
Publisher: CRC Press
Release Date : 2015-08-03

Textbook Of The Neurogenic Bladder written by Jacques Corcos and has been published by CRC Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2015-08-03 with Medical categories.

The editors of this comprehensive third edition of the Textbook of the Neurogenic Bladder have assembled an impressive team of world specialists to develop an essential resource for physicians, continence specialists, and other health care professionals involved in the diagnosis and management of patients who have lost normal bladder function.The b

Essentials Of The Adult Neurogenic Bladder

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Author : Jaques Corcos
language : en
Publisher: CRC Press
Release Date : 2020-10-16

Essentials Of The Adult Neurogenic Bladder written by Jaques Corcos and has been published by CRC Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2020-10-16 with Medical categories.

This book summarises the entire field of adult neuro-urology in a concise, well-illustrated, and practical style. Contents include epidemiology, lower urinary tract anatomy and physiology. This is followed by coverage of the pathophysiology of various types of voiding dysfunctions and a clinical section focusing on practical evaluation and treatment. A range of treatments from behavioral, pharmacological, intra vesical, tissue engineering and surgical are explained and reviewed. Other topics such as complications, sexual function, fertility, maternity aspects, and prognostic factors round off the book. *Each topic is covered in detail and well illustrated. *The reader will gain a full understanding of every aspect of adult neuro-urology. *Facilitates improved clinical knowledge and practice. Provides an essential and complete reference tool for students and established urologists, neurologists, physiotherapists and nurses, and technicians involved in the care of patients with neurogenic bladder dysfunction.

Pelvic Organ Dysfunction In Neurological Disease

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Author : Clare J. Fowler
language : en
Publisher: Cambridge University Press
Release Date : 2010-11-04

Pelvic Organ Dysfunction In Neurological Disease written by Clare J. Fowler and has been published by Cambridge University Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2010-11-04 with Medical categories.

Pelvic Organ Dysfunction in Neurological Disease describes the neurological control of human bladder, bowel and sexual function and then details the dysfunctions which may arise as a consequence of various neurological diseases. Easy to read, the book will be of value to any healthcare professional managing patients in whom pelvic organ functions have been compromised by neurological disease. The book provides a structured approach to present day understanding of the neurological control of pelvic organs and the investigation and management of each type of organ dysfunction. A unique feature of this book is that it addresses the impact of specific neurological disorders on all three functions. The authors have all been associated with the Department of Uro-Neurology at the National Hospital for Neurology and Neurosurgery, London since it was established 20 years ago. This book is a timely review of their accumulated knowledge and the latest literature.