Radiofrequency Sacral Rhizotomy for the Management of Intolerable Neurogenic Bladder in Spinal Cord Injured Patients.
10.5535/arm.2012.36.2.213
- Author:
Kang Hee CHO
1
;
Sang Sook LEE
Author Information
1. Department of Rehabilitation Medicine, Chungnam National University School of Medicine, Daejeon 301-172, Korea. drlovingss@naver.com
- Publication Type:Original Article
- Keywords:
Spinal cord injury;
Neurogenic bladder;
Hyperactive detrusor muscle;
Radiofrequency;
Sacral rhizotomy
- MeSH:
Humans;
Intermittent Urethral Catheterization;
Rhizotomy;
Spinal Cord;
Spinal Cord Injuries;
Urinary Bladder;
Urinary Bladder, Neurogenic;
Urinary Incontinence;
Urodynamics;
Vesico-Ureteral Reflux
- From:Annals of Rehabilitation Medicine
2012;36(2):213-219
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To investigate the effect of radiofrequency (RF) sacral rhizotomy of the intolerable neurogenic bladder in spinal cord injured patients. METHOD: Percutaneous RF sacral rhizotomy was performed on 12 spinal cord injured patients who had neurogenic bladder manifested with urinary incontinence resisted to an oral and intravesical anticholinergic instillation treatment. Various combinations of S2, S3, and S4 RF rhizotomies were performed. The urodynamic study (UDS) was performed 1 week before RF rhizotomy. The voiding cystourethrogram (VCUG) and voiding diaries were compared 1 week before and 4 weeks after therapy. Total volume of daily urinary incontinence (ml/day) and clean intermittent catheterization (ml/time) volume of each time were also monitored. RESULTS: After RF sacral rhizotomy, bladder capacity increased in 9 patients and the amount of daily urinary incontinence decreased in 11 patients. The mean maximal bladder capacity increased from 292.5 to 383.3 ml (p<0.05) and mean daily incontinent volume decreased from 255 to 65 ml (p<0.05). Bladder trabeculation and vesicoureteral reflux findings did not change 4 weeks after therapy. CONCLUSION: This study revealed that RF sacral rhizotomy was an effective method for neurogenic bladder with uncontrolled incontinence using conventional therapy among spinal cord injured patients.
