Loading…
Pathophysiology, Clinical Importance, and Management of Neurogenic Lower Urinary Tract Dysfunction Caused by Suprasacral Spinal Cord Injury
Management of persistent lower urinary tract dysfunction resulting from severe thoracolumbar spinal cord injury can be challenging. Severe suprasacral spinal cord injury releases the spinal cord segmental micturition reflex from supraspinal modulation and increases nerve growth factor concentration...
Saved in:
Published in: | Journal of veterinary internal medicine 2016-09, Vol.30 (5), p.1575-1588 |
---|---|
Main Authors: | , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
cited_by | cdi_FETCH-LOGICAL-c4207-ae2ececaa44b94fae98a5b32d160175e3adf21962ccf4a9052bfff9a18df6bd43 |
---|---|
cites | cdi_FETCH-LOGICAL-c4207-ae2ececaa44b94fae98a5b32d160175e3adf21962ccf4a9052bfff9a18df6bd43 |
container_end_page | 1588 |
container_issue | 5 |
container_start_page | 1575 |
container_title | Journal of veterinary internal medicine |
container_volume | 30 |
creator | Hu, H.Z. Granger, N. Jeffery, N.D. |
description | Management of persistent lower urinary tract dysfunction resulting from severe thoracolumbar spinal cord injury can be challenging. Severe suprasacral spinal cord injury releases the spinal cord segmental micturition reflex from supraspinal modulation and increases nerve growth factor concentration in the bladder wall, lumbosacral spinal cord, and dorsal root ganglion, which subsequently activates hypermechanosensitive C‐fiber bladder wall afferents. Hyperexcitability of bladder afferents and detrusor overactivity can cause urine leaking during the storage phase. During urine voiding, the loss of supraspinal control that normally coordinates detrusor contraction with sphincter relaxation can lead to spinal cord segmental reflex‐mediated simultaneous detrusor and sphincter contractions or detrusor‐sphincter dyssynergia, resulting in inefficient urine voiding and high residual volume. These disease‐associated changes can impact on the quality of life and life expectancy of spinal‐injured animals. Here, we discuss the pathophysiology and management considerations of lower urinary tract dysfunction as the result of severe, acute, suprasacral spinal cord injury. In addition, drawing from experimental, preclinical, and clinical medicine, we introduce some treatment options for neurogenic lower urinary tract dysfunction that are designed to: (1) prevent urine leakage arising because of detrusor overactivity during bladder filling, (2) preserve upper urinary tract integrity and function by reducing intravesical pressure and subsequent vesicoureteral reflux, and (3) prevent urinary tract and systemic complications by treating and preventing urinary tract infections. |
doi_str_mv | 10.1111/jvim.14557 |
format | article |
fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5032886</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1835365185</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4207-ae2ececaa44b94fae98a5b32d160175e3adf21962ccf4a9052bfff9a18df6bd43</originalsourceid><addsrcrecordid>eNp9kcFu1DAQhi0EokvhwgMgHxFqiu3ETnJBQoHCoi0gteVqTRx716vEDnbSKs_Ql8ZlSwUX5jKH-fTNjH6EXlJySlO93V_b4ZQWnJeP0IrWeZ1RUYrHaEWqmmZCFOQIPYtxTwjjCXqKjljJWZlXbIVuv8O08-Nuidb3fruc4Ka3ziro8XoYfZjAKX2CwXX4HBxs9aDdhL3BX_Uc_FYnFG_8jQ74KlgHYcGXAdSEPyzRzE5N1jvcwBx1h9sFX8xjgAgqJP3FmPgeNz50eO32c1ieoycG-qhf3PdjdHX28bL5nG2-fVo37zeZKhgpM9BMK60AiqKtCwO6roC3OeuoILTkOofOMFoLppQpoCactcaYGmjVGdF2RX6M3h2849wOulPpo3SQHIMd0gPSg5X_Tpzdya2_lpzkrKpEEry-FwT_c9ZxkoONSvc9OO3nKGmV81xwWvGEvjmgKvgYgzYPayiRd-nJu_Tk7_QS_Orvwx7QP3ElgB6AG9vr5T8q-eXH-vwg_QXKP6ph</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1835365185</pqid></control><display><type>article</type><title>Pathophysiology, Clinical Importance, and Management of Neurogenic Lower Urinary Tract Dysfunction Caused by Suprasacral Spinal Cord Injury</title><source>Open Access: Wiley-Blackwell Open Access Journals</source><source>PubMed Central</source><creator>Hu, H.Z. ; Granger, N. ; Jeffery, N.D.</creator><creatorcontrib>Hu, H.Z. ; Granger, N. ; Jeffery, N.D.</creatorcontrib><description>Management of persistent lower urinary tract dysfunction resulting from severe thoracolumbar spinal cord injury can be challenging. Severe suprasacral spinal cord injury releases the spinal cord segmental micturition reflex from supraspinal modulation and increases nerve growth factor concentration in the bladder wall, lumbosacral spinal cord, and dorsal root ganglion, which subsequently activates hypermechanosensitive C‐fiber bladder wall afferents. Hyperexcitability of bladder afferents and detrusor overactivity can cause urine leaking during the storage phase. During urine voiding, the loss of supraspinal control that normally coordinates detrusor contraction with sphincter relaxation can lead to spinal cord segmental reflex‐mediated simultaneous detrusor and sphincter contractions or detrusor‐sphincter dyssynergia, resulting in inefficient urine voiding and high residual volume. These disease‐associated changes can impact on the quality of life and life expectancy of spinal‐injured animals. Here, we discuss the pathophysiology and management considerations of lower urinary tract dysfunction as the result of severe, acute, suprasacral spinal cord injury. In addition, drawing from experimental, preclinical, and clinical medicine, we introduce some treatment options for neurogenic lower urinary tract dysfunction that are designed to: (1) prevent urine leakage arising because of detrusor overactivity during bladder filling, (2) preserve upper urinary tract integrity and function by reducing intravesical pressure and subsequent vesicoureteral reflux, and (3) prevent urinary tract and systemic complications by treating and preventing urinary tract infections.</description><identifier>ISSN: 0891-6640</identifier><identifier>EISSN: 1939-1676</identifier><identifier>DOI: 10.1111/jvim.14557</identifier><identifier>PMID: 27527382</identifier><language>eng</language><publisher>United States: John Wiley and Sons Inc</publisher><subject>Animals ; Cat Diseases - etiology ; Cat Diseases - physiopathology ; Cat Diseases - therapy ; Cats - injuries ; Cystometry ; Dog ; Dog Diseases - etiology ; Dog Diseases - physiopathology ; Dog Diseases - therapy ; Dogs - injuries ; Review ; Small Animal ; Spinal ; Spinal Cord Injuries - complications ; Spinal Cord Injuries - veterinary ; Urinary ; Urinary Bladder, Neurogenic - etiology ; Urinary Bladder, Neurogenic - physiopathology ; Urinary Bladder, Neurogenic - therapy ; Urinary Bladder, Neurogenic - veterinary ; Urodynamics</subject><ispartof>Journal of veterinary internal medicine, 2016-09, Vol.30 (5), p.1575-1588</ispartof><rights>Copyright © 2016 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4207-ae2ececaa44b94fae98a5b32d160175e3adf21962ccf4a9052bfff9a18df6bd43</citedby><cites>FETCH-LOGICAL-c4207-ae2ececaa44b94fae98a5b32d160175e3adf21962ccf4a9052bfff9a18df6bd43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5032886/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5032886/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,11562,27924,27925,46052,46476,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27527382$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hu, H.Z.</creatorcontrib><creatorcontrib>Granger, N.</creatorcontrib><creatorcontrib>Jeffery, N.D.</creatorcontrib><title>Pathophysiology, Clinical Importance, and Management of Neurogenic Lower Urinary Tract Dysfunction Caused by Suprasacral Spinal Cord Injury</title><title>Journal of veterinary internal medicine</title><addtitle>J Vet Intern Med</addtitle><description>Management of persistent lower urinary tract dysfunction resulting from severe thoracolumbar spinal cord injury can be challenging. Severe suprasacral spinal cord injury releases the spinal cord segmental micturition reflex from supraspinal modulation and increases nerve growth factor concentration in the bladder wall, lumbosacral spinal cord, and dorsal root ganglion, which subsequently activates hypermechanosensitive C‐fiber bladder wall afferents. Hyperexcitability of bladder afferents and detrusor overactivity can cause urine leaking during the storage phase. During urine voiding, the loss of supraspinal control that normally coordinates detrusor contraction with sphincter relaxation can lead to spinal cord segmental reflex‐mediated simultaneous detrusor and sphincter contractions or detrusor‐sphincter dyssynergia, resulting in inefficient urine voiding and high residual volume. These disease‐associated changes can impact on the quality of life and life expectancy of spinal‐injured animals. Here, we discuss the pathophysiology and management considerations of lower urinary tract dysfunction as the result of severe, acute, suprasacral spinal cord injury. In addition, drawing from experimental, preclinical, and clinical medicine, we introduce some treatment options for neurogenic lower urinary tract dysfunction that are designed to: (1) prevent urine leakage arising because of detrusor overactivity during bladder filling, (2) preserve upper urinary tract integrity and function by reducing intravesical pressure and subsequent vesicoureteral reflux, and (3) prevent urinary tract and systemic complications by treating and preventing urinary tract infections.</description><subject>Animals</subject><subject>Cat Diseases - etiology</subject><subject>Cat Diseases - physiopathology</subject><subject>Cat Diseases - therapy</subject><subject>Cats - injuries</subject><subject>Cystometry</subject><subject>Dog</subject><subject>Dog Diseases - etiology</subject><subject>Dog Diseases - physiopathology</subject><subject>Dog Diseases - therapy</subject><subject>Dogs - injuries</subject><subject>Review</subject><subject>Small Animal</subject><subject>Spinal</subject><subject>Spinal Cord Injuries - complications</subject><subject>Spinal Cord Injuries - veterinary</subject><subject>Urinary</subject><subject>Urinary Bladder, Neurogenic - etiology</subject><subject>Urinary Bladder, Neurogenic - physiopathology</subject><subject>Urinary Bladder, Neurogenic - therapy</subject><subject>Urinary Bladder, Neurogenic - veterinary</subject><subject>Urodynamics</subject><issn>0891-6640</issn><issn>1939-1676</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><recordid>eNp9kcFu1DAQhi0EokvhwgMgHxFqiu3ETnJBQoHCoi0gteVqTRx716vEDnbSKs_Ql8ZlSwUX5jKH-fTNjH6EXlJySlO93V_b4ZQWnJeP0IrWeZ1RUYrHaEWqmmZCFOQIPYtxTwjjCXqKjljJWZlXbIVuv8O08-Nuidb3fruc4Ka3ziro8XoYfZjAKX2CwXX4HBxs9aDdhL3BX_Uc_FYnFG_8jQ74KlgHYcGXAdSEPyzRzE5N1jvcwBx1h9sFX8xjgAgqJP3FmPgeNz50eO32c1ieoycG-qhf3PdjdHX28bL5nG2-fVo37zeZKhgpM9BMK60AiqKtCwO6roC3OeuoILTkOofOMFoLppQpoCactcaYGmjVGdF2RX6M3h2849wOulPpo3SQHIMd0gPSg5X_Tpzdya2_lpzkrKpEEry-FwT_c9ZxkoONSvc9OO3nKGmV81xwWvGEvjmgKvgYgzYPayiRd-nJu_Tk7_QS_Orvwx7QP3ElgB6AG9vr5T8q-eXH-vwg_QXKP6ph</recordid><startdate>201609</startdate><enddate>201609</enddate><creator>Hu, H.Z.</creator><creator>Granger, N.</creator><creator>Jeffery, N.D.</creator><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201609</creationdate><title>Pathophysiology, Clinical Importance, and Management of Neurogenic Lower Urinary Tract Dysfunction Caused by Suprasacral Spinal Cord Injury</title><author>Hu, H.Z. ; Granger, N. ; Jeffery, N.D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4207-ae2ececaa44b94fae98a5b32d160175e3adf21962ccf4a9052bfff9a18df6bd43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Animals</topic><topic>Cat Diseases - etiology</topic><topic>Cat Diseases - physiopathology</topic><topic>Cat Diseases - therapy</topic><topic>Cats - injuries</topic><topic>Cystometry</topic><topic>Dog</topic><topic>Dog Diseases - etiology</topic><topic>Dog Diseases - physiopathology</topic><topic>Dog Diseases - therapy</topic><topic>Dogs - injuries</topic><topic>Review</topic><topic>Small Animal</topic><topic>Spinal</topic><topic>Spinal Cord Injuries - complications</topic><topic>Spinal Cord Injuries - veterinary</topic><topic>Urinary</topic><topic>Urinary Bladder, Neurogenic - etiology</topic><topic>Urinary Bladder, Neurogenic - physiopathology</topic><topic>Urinary Bladder, Neurogenic - therapy</topic><topic>Urinary Bladder, Neurogenic - veterinary</topic><topic>Urodynamics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hu, H.Z.</creatorcontrib><creatorcontrib>Granger, N.</creatorcontrib><creatorcontrib>Jeffery, N.D.</creatorcontrib><collection>Open Access: Wiley-Blackwell Open Access Journals</collection><collection>Wiley Online Library Free Content</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of veterinary internal medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hu, H.Z.</au><au>Granger, N.</au><au>Jeffery, N.D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pathophysiology, Clinical Importance, and Management of Neurogenic Lower Urinary Tract Dysfunction Caused by Suprasacral Spinal Cord Injury</atitle><jtitle>Journal of veterinary internal medicine</jtitle><addtitle>J Vet Intern Med</addtitle><date>2016-09</date><risdate>2016</risdate><volume>30</volume><issue>5</issue><spage>1575</spage><epage>1588</epage><pages>1575-1588</pages><issn>0891-6640</issn><eissn>1939-1676</eissn><abstract>Management of persistent lower urinary tract dysfunction resulting from severe thoracolumbar spinal cord injury can be challenging. Severe suprasacral spinal cord injury releases the spinal cord segmental micturition reflex from supraspinal modulation and increases nerve growth factor concentration in the bladder wall, lumbosacral spinal cord, and dorsal root ganglion, which subsequently activates hypermechanosensitive C‐fiber bladder wall afferents. Hyperexcitability of bladder afferents and detrusor overactivity can cause urine leaking during the storage phase. During urine voiding, the loss of supraspinal control that normally coordinates detrusor contraction with sphincter relaxation can lead to spinal cord segmental reflex‐mediated simultaneous detrusor and sphincter contractions or detrusor‐sphincter dyssynergia, resulting in inefficient urine voiding and high residual volume. These disease‐associated changes can impact on the quality of life and life expectancy of spinal‐injured animals. Here, we discuss the pathophysiology and management considerations of lower urinary tract dysfunction as the result of severe, acute, suprasacral spinal cord injury. In addition, drawing from experimental, preclinical, and clinical medicine, we introduce some treatment options for neurogenic lower urinary tract dysfunction that are designed to: (1) prevent urine leakage arising because of detrusor overactivity during bladder filling, (2) preserve upper urinary tract integrity and function by reducing intravesical pressure and subsequent vesicoureteral reflux, and (3) prevent urinary tract and systemic complications by treating and preventing urinary tract infections.</abstract><cop>United States</cop><pub>John Wiley and Sons Inc</pub><pmid>27527382</pmid><doi>10.1111/jvim.14557</doi><tpages>14</tpages><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0891-6640 |
ispartof | Journal of veterinary internal medicine, 2016-09, Vol.30 (5), p.1575-1588 |
issn | 0891-6640 1939-1676 |
language | eng |
recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5032886 |
source | Open Access: Wiley-Blackwell Open Access Journals; PubMed Central |
subjects | Animals Cat Diseases - etiology Cat Diseases - physiopathology Cat Diseases - therapy Cats - injuries Cystometry Dog Dog Diseases - etiology Dog Diseases - physiopathology Dog Diseases - therapy Dogs - injuries Review Small Animal Spinal Spinal Cord Injuries - complications Spinal Cord Injuries - veterinary Urinary Urinary Bladder, Neurogenic - etiology Urinary Bladder, Neurogenic - physiopathology Urinary Bladder, Neurogenic - therapy Urinary Bladder, Neurogenic - veterinary Urodynamics |
title | Pathophysiology, Clinical Importance, and Management of Neurogenic Lower Urinary Tract Dysfunction Caused by Suprasacral Spinal Cord Injury |
url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-23T00%3A50%3A06IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Pathophysiology,%20Clinical%20Importance,%20and%20Management%20of%20Neurogenic%20Lower%20Urinary%20Tract%20Dysfunction%20Caused%20by%20Suprasacral%20Spinal%20Cord%20Injury&rft.jtitle=Journal%20of%20veterinary%20internal%20medicine&rft.au=Hu,%20H.Z.&rft.date=2016-09&rft.volume=30&rft.issue=5&rft.spage=1575&rft.epage=1588&rft.pages=1575-1588&rft.issn=0891-6640&rft.eissn=1939-1676&rft_id=info:doi/10.1111/jvim.14557&rft_dat=%3Cproquest_pubme%3E1835365185%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c4207-ae2ececaa44b94fae98a5b32d160175e3adf21962ccf4a9052bfff9a18df6bd43%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=1835365185&rft_id=info:pmid/27527382&rfr_iscdi=true |