척수 손상 환자의 신경인성 방광에서 방광 신장 치료법

Abstract

Objective: To evaluate the effect of stretching therapy of neurogenic bladder in spinal cord injured patients. Method: Twelve spinal cord injured patients who had neurogeic bladder manifested with urinary incontinence resistant to oral and intravesical anticholinergic instillation treatment were selected. Oxybutynin solution was instillated via foley catheter and the catheter was clamped until incontinence occur. This was performed twice a day for 7 days. The urodynamic studies were compared before and after therapy. Total volume of daily incontinence and total volume of daily fluid intake were also monitored.

Results: After stretching therapy, median maximal bladder capacity increased from 190.08 to 457.17 ml (p＜0.01), mean bladder compliance increased from 8.46 to 18.85 ml/cmH2O (p＜0.01), mean reflex volume increased from 148.75 to 252.17 ml (p＜0.05), mean maximal detrusor pressure decreased from 52.17 to 28.29 cmH2O (p＜0.01), mean clinical maximal capacity increased from 277.50 to 537.50 ml (p＜0.01), and mean daily incontinent volume decreased from 508.33 ml to 20.83 ml (p＜0.01). No significant correlation was found between the duration since onset of injury and the urodynamic finding.

Conclusion: This study proved that stretching therapy of bladder was an effective method in spinal cord injured patients who had neurogenic bladder with uncontrolled incontinence with conventional therapy.