척수 손상 환자의 방광 요관 역류에서 보존적 치료의 효과

Abstract

Objective: To evaluate the effectiveness of conservative treatment for the vesicoureteral reflux (VUR) in spinal cord injured patients.

Method: Twelve spinal cord injured patients were diagnosed as VUR which was graded as the International Classification System by voiding cystourethrography (VCUG). They received conservative treatment including clean intermittent catheterization, administration of anticholinergics and intravesical oxybutynin instillation therapy. Pre-treatment urodynamic studies and VCUG were compared with follow-up studies after conservative treatment. The results of follow-up VCUG were graded as controlled or remained group.

Results: After conservative treatment, VUR was controlled in 8 patients (67.0%) and remained in 4 patients (33.0%). On urodynamic studies after conservative treatment, mean maximal bladder capacity increased from 225.0 to 370.6 ml (p＜0.05), mean bladder compliance increased from 12.1 to 31.5 ml/cmH2O (p＜0.05), mean maximal detrusor pressure decreased from 63.8 to 21.8 cmH2O (p＜0.05) in controlled group. But in remained group, there was no significant difference between pre & post-treatment. There was singnificant difference in change ratio of maximal detrusor pressure between two groups (p＜0.05).

Conclusion: This study showed 67.0% controlled rate of VUR by VCUG with improved urodynamic parameters after conservative treatment. We conclude that VUR can be effectively managed by the conservative method in spinal cord injured patients.