1.Intravesical Sodium Chondroitin Sulphate to Treat Overactive Bladder: Preliminary Result.
Lokman IRKILATA ; Mustafa AYDIN ; Hasan Riza AYDIN ; Huseyin CIHAN DEMIREL ; Mustafa KADIHASANOGLU ; Mustafa Kemal ATILLA
International Neurourology Journal 2015;19(2):85-89
PURPOSE: This study aimed to verify the efficacy and safety of intravesical treatment with sodium chondroitin sulfate (CS) in patients with overactive bladder (OAB) who are refractory to previous antimuscarinic treatment. METHODS: This study was performed between June 2012 and January 2015 and included 31 consecutive women (mean age, 42.10+/-7.34 years) with OAB who had been previously treated with two types of antimuscarinic drugs. The results of gynecologic and cystoscopic examinations were normal, and OAB comorbidity was absent. Treatment with intravesical instillations containing 40 mL CS (0.2%; 2 mg/mL) was administered for 6 weeks; after weekly treatments, monthly treatments were administered. The OAB-validated 8 (OAB-V8) symptom scores, nocturia, frequency, urgency, urge incontinence, and urinary volumes measured by uroflowmetry were evaluated for all the patients. The values obtained before the treatment were statistically compared with those obtained six months after the treatment. RESULTS: The duration of the symptoms was 18.36+/-6.19 months. A statistically significant improvement of the patients' conditions was observed in terms of the OAB-V8 symptom scores, nocturia, frequency, urgency, urge incontinence, and urinary volumes measured by uroflowmetry after the treatment. CONCLUSIONS: Despite the limitations of this study, the outcomes confirmed that CS therapy is safe and effective for the treatment of OAB.
Administration, Intravesical
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Chondroitin Sulfates
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Chondroitin*
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Comorbidity
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Female
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Humans
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Nocturia
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Sodium*
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Urinary Bladder, Overactive*
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Urinary Incontinence, Urge
2.Disc Rehydration after Dynamic Stabilization: A Report of 59 Cases.
Atilla YILMAZ ; Salim SENTURK ; Mehdi SASANI ; Tunc OKTENOGLU ; Onur YAMAN ; Hakan YILDIRIM ; Tuncer SUZER ; Ali Fahir OZER
Asian Spine Journal 2017;11(3):348-355
STUDY DESIGN: A retrospective study investigating decrease in the nucleus pulposus signal intensity or disc height on magnetic resonance imaging (MRI) and disc degeneration. PURPOSE: Although a degenerated disc cannot self-regenerate, distraction or stabilization may provide suitable conditions for rehydration and possible regeneration. This study aimed to evaluate clinical outcomes and disc regeneration via MRI in a series of patients with degenerative disc disease (DDD) who underwent lumbar stabilization with a dynamic stabilization system (DSS). OVERVIEW OF LITERATURE: A dynamic system provides rehydration during early DDD. METHODS: Fifty-nine patients (mean age, 46.5 years) who undedwent stabilization with DSS for segmental instability (painful black disc) between 2004 and 2014 were retrospectively evaluated. All patients underwent MRI preoperatively and 12 months postoperatively. Intervertebral disc (IVD) degeneration grades at the implanted segment were categorized using the Pfirrmann classification system. Patients were followed for a mean of 6.4 years, and clinical outcomes were based on visual analog scale (VAS) and Oswestry disability index (ODI) scores. RESULTS: Significant improvements in back pain VAS and ODI scores from before surgery (7 and 68%, respectively) were reported at 6 (2.85 and 27.4%, respectively) and 12 months postoperatively (1.8 and 16.3%, respectively). Postoperative IVD changes were observed in 28 patients. Improvement was observed in 20 patients (34%), whereas progressive degeneration was observed in eight patients (13.5%). Thirty-one patients (52.5%) exhibited neither improvement nor progression. Single Pfirrmann grade improvements were observed in 29% of the patients and two-grade improvements were observed in 5%. CONCLUSIONS: Our observations support the theory that physiological movement and a balanced load distribution are necessary for disc regeneration. We conclude that DSS may decelerate the degeneration process and appears to facilitate regeneration.
Back Pain
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Classification
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Dichlorodiphenyldichloroethane
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Fluid Therapy*
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Humans
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Intervertebral Disc
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Intervertebral Disc Degeneration
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Magnetic Resonance Imaging
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Regeneration
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Retrospective Studies
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Visual Analog Scale