Macroplastique and Botox are superior to Macroplastique alone in the management of neurogenic vesicoureteric reflux in spinal cord injury population with presumed healthy bladders

Autor: Rachel Oliver, Melissa C Davies, Vasileios Sakalis, Peter Guy
Rok vydání: 2018
Předmět:
Adult
Male
medicine.medical_specialty
Urinary Bladder
Population
030232 urology & nephrology
Urology
Context (language use)
urologic and male genital diseases
Young Adult
03 medical and health sciences
0302 clinical medicine
Clinical endpoint
medicine
Humans
Dimethylpolysiloxanes
Prospective Studies
Botulinum Toxins
Type A
Urinary Bladder
Neurogenic
education
Spinal cord injury
Spinal Cord Injuries
Research Articles
Aged
Retrospective Studies
Vesico-Ureteral Reflux
education.field_of_study
business.industry
Reflux
Disease Management
Middle Aged
medicine.disease
Botulinum toxin
female genital diseases and pregnancy complications
Treatment Outcome
Macroplastique
030220 oncology & carcinogenesis
Drug Therapy
Combination
Female
Neurology (clinical)
Complication
business
Follow-Up Studies
medicine.drug
Zdroj: J Spinal Cord Med
ISSN: 2045-7723
1079-0268
DOI: 10.1080/10790268.2018.1433266
Popis: CONTEXT/OBJECTIVE: Vesico-ureteric reflux(VUR) is a known complication of neuropathic bladder in spinal cord injury(SCI) population. Bulking agents such as Macroplastique are new minimally-invasive treatment option for VUR with good results. The aim of this study is to assess the efficacy of Macroplastique alone or in combination with Botox(BTX-A), in managing VUR in SCI population with presumed healthy bladders and correlate the pre-and post-injection urodynamic findings with the outcome. DESIGN: Retrospective comparative study. PARTICIPANTS: SCI patients with VUR and presumed health bladders (normo-compliant, low filling pressures), treated with macroplastique alone or in combination with BTX-A, who had pre and post-intervention Video-urodynamics (VUDS) and followed up for at least 12 months. INTERVENTIONS: Macroplastique and BTX-A injections, VUDS. OUTCOME MEASURES: The primary end point was the overall treatment rate of VUR at 3 months and the secondary outcomes were the success rate (treated + improved) and the comparison of urodynamic parameters (pre-and post-injection). RESULTS: We studied 34 intervention-naïve SCI patients. 19 had only Macroplastique (Group 1) and 15 had Macroplastique and BTX-A (Group 2). The overall treatment rate was 65.4% for group 1 and 88.9% for group 2 (P = 0.029). The overall success rate (treated + improved) was 80.8% and 94.4% respectively (P = 0.123). The comparison of follow up VUDS parameters showed a statistically significant rise in the detrusor pressure of group 1 (34.04cmH2O vs.19.2cmH2O, P = 0.008) and a drop in compliance (19.8mls/cmH2O vs.26.3mls/cmH2O, P = 0.018) as compared to baseline. CONCLUSION: The combination of BTX-A and Macroplastique is more effective that Macroplastique alone in the management of secondary VUR in SCI patients with presumed healthy bladders.
Databáze: OpenAIRE
Externí odkaz: