Endoscopic correction of vesicoureteral reflux in patients with neurogenic bladder dysfunction.

Transurethral injection of Teflon paste (TUI) was carried out in 24 ureters of 16 patients with vesicoureteral reflux (VUR) secondary to neurogenic bladder dysfunction at an age ranging from 4 to 77 years, and the results were compared with those of conventional open surgery. During the mean follow-up period of 20.1 months, reflux disappeared in 19 ureters (79%), so that the success rate of endoscopic operation was considered to be satisfactory as compared with that of conventional open surgery, in which reflux disappeared in 16 (80%) of 20 ureters in 16 patients with neurogenic bladder dysfunction at our department. No exacerbation of hydronephrosis was observed postoperatively, and no complication was noted. This procedure, which is minimally invasive and technically simple, may be regarded as the first choice for VUR secondary to neurogenic bladder dysfunction.

[Clinical study of terodiline hydrochloride on nervous pollakisuria].

TD-758 (12 mg tablets) was given in two tablets daily to 19 patients with nervous pollakisuria. The changes in frequency of daily micturition and in subjective symptoms were studied referring to the diary kept by each patient, along with the occurrence of side effects. Before the medication, urodynamic studies were made on each patient and all the cases were thus confirmed being free from detrusor instability or uninhibited contraction. The wash-out period of other drugs and control observation period, each one week, were set before the medication period which lasted for four weeks. The frequency of micturition per day showed a significant decrease from the first week of the medication period (p less than 0.05), and at the fourth week there was noted a significant reduction by twice per day on the average (p less than 0.001). Subjective efficacy was noted as follows: excellent in 3 cases (15.8%), good in 9 cases (47.7%), unchanged in 7 cases (36.8%), and thus 12 cases (63.2%) showed an efficacy of the rating of good or higher. In four cases dry mouth and in two cases sense of abdominal distention were noted out of the total of 19 cases, but no side effects of severe degree to stop the medication were noted during the medication period. In conclusion TD-758 is a clinically useful remedy for treatment of nervous pollakisuria.