Assuntos
Disgerminoma/complicações , Exoftalmia/etiologia , Ginecomastia/etiologia , Neoplasias do Mediastino/complicações , Doenças da Aorta/patologia , Atrofia , Sulfato de Bário , Núcleo Celular , Citoplasma , Disgerminoma/diagnóstico por imagem , Disgerminoma/patologia , Humanos , Masculino , Neoplasias do Mediastino/diagnóstico por imagem , Neoplasias do Mediastino/patologia , Pessoa de Meia-Idade , Metástase Neoplásica , Doença Cardiopulmonar/etiologia , Radiografia , Neoplasias Testiculares/patologia , Testículo/patologia , Timo/patologia , Neoplasias da Traqueia/patologiaRESUMO
The pharmacodynamics of baclofen on the bladder and urethral sphincters in acute and chronic spinal cord injury male patients were evaluated. A total of 100 supine and sitting urodynamic profiles was done in 25 patients. Baclofen decreased external urethral sphincter resistance by depressing pudendal-to-pudendal nerve reflex through spinal cord presynaptic hyperpolarization. This new centrally acting antispastic drug produced a significant reduction of residual urine in 73 per cent of the cases within an average of 4.98 weeks. Baclofen is a new alternative in the medical treatment of postural non-electrically induced detrusor striated sphincter dyssynergia in spinal cord injury patients. Indications for external sphincterotomy are discussed.
Assuntos
Baclofeno/uso terapêutico , Traumatismos da Medula Espinal/complicações , Transtornos Urinários/tratamento farmacológico , Adulto , Baclofeno/administração & dosagem , Baclofeno/farmacologia , Humanos , Masculino , Pessoa de Meia-Idade , Uretra/efeitos dos fármacos , Bexiga Urinária/efeitos dos fármacosRESUMO
There were 17 spinal cord injury men with drug-resistant pain who were treated with transcutaneous nerve stimulation. Bladder and sphincter dysfunctions were evaluated by gas cystosphincterometry and rectal sphinctero-electromyography with the patient in 2 different positions. With the use of transcutaneous nerve stimulation for pain we noted no demonstrable urodynamic changes in acute and chronic paraplegics and chronic quadriplegics. However, there was an increase in the urethral pressures and in the rectal electromyogram spike potentials in acute and recent (less than 2 years post-injury) quadriplegics with postural detrusor-striated sphincter dyssynergia. Therefore, caution is necessary when transcutaneous nerve stimulation is used in this particular group of patients since it might be detrimental to the genitourinary tract.
Assuntos
Terapia por Estimulação Elétrica , Manejo da Dor , Traumatismos da Medula Espinal/fisiopatologia , Uretra/fisiopatologia , Bexiga Urinaria Neurogênica/fisiopatologia , Bexiga Urinária/fisiopatologia , Urodinâmica , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Traumatismos da Medula Espinal/complicaçõesRESUMO
The neuropharmacodynamics of bethanechol chloride on the external urethral sphincter in male spinal cord injury patients with chronic lesions have been investigated. There were 90 cystosphincterometric and sphincteroperineal electromyographic studies conducted on 45 subjects in 4 different positions, showing varying urodynamic patterns. A gross postural cystophincteric discordant reflex was noted in the majority of patients with recent complete upper motor neuron bladders (less than 2 years in duration). The external sphincter tends to be coordinated in late cases of quadriplegics and in all paraplegics. With the administration of bethanechol chloride there was an increase in the striated sphincter pressure profile when the patient was in the sitting position, resulting in detrusor sphincter dyssnergia. This phenomenon seems to be dose-related. When the dose of bethanechol chloride is adjusted according to the types of vesicourethral dysfunctions or in combination with dantrolene sodium the most beneficial non-surgical rehabilitation of the urinary tract can be obtained in this particular group of patients.