Abstract
Study design:A retrospective study.Objectives:To investigate the effect of imidafenacin on the urodynamic parameters of patients with indwelling bladder catheters due to spinal cord injury (SCI).Setting:Spinal center (Tokyo, Japan).Methods:Imidafenacin was prescribed to 34 patients with SCI who had a low cystometric volume and/or detrusor compliance according to a urodynamic study. A low cystometric volume and detrusor compliance were defined as <200 ml and <20 ml cm−1 H2O, respectively. The urodynamic study was repeated 4 weeks after imidafenacin was prescribed. When the urodynamic parameters did not improve in the follow-up study, the dose of imidafenacin was increased twofold. Then the urodynamic study was repeated 4 weeks thereafter. We compared the urodynamic parameters before and after imidafenacin treatment. Complications such as vesico-urethral reflux (VUR) and autonomic dysreflexia (AD) were documented.Results:Fifteen patients took 0.2 mg of imidafenacin daily, and 19 received 0.4 mg of imidafenacin daily. Imidafenacin increased the cystometric volume from 246.0 to 321.5 ml (median, P=0.002), detrusor compliance from 6.67 ml cm−1 H2O to 8.98 ml cm−1 H2O (median, P=0.012), and decreased the detrusor pressure from 37.0 cm H2O to 30.5 cm H2O (median, P=0.056). All three patients who had VUR fully recovered. Although 3 of 12 patients recovered from AD, 3 patients newly developed symptoms of AD. No patient withdrew from treatment due to adverse effects.Conclusion:Imidafenacin is a safe drug that may improve the urodynamic parameters of patients with SCI, and it possibly alleviates bladder complications.
Highlights
Patients with spinal cord injury (SCI) often have detrusor overactivity in combination with detrusor-sphincter dyssynergia.[1]This pathological condition results in urological complications, for example, bladder deformity, a low bladder compliance and vesico-urethral reflux (VUR).[1]
It should be noted that clean intermittent catheterization (CIC) can still cause urethral trauma and genital infection.[5,6]
MATERIALS AND METHODS We retrospectively reviewed the records of all patients who were treated with imidafenacin for neurogenic lower urinary tract dysfunction and had indwelling catheters due to SCI, and had undergone video urodynamic examination at our institution between July 2010 and December 2012
Summary
Patients with spinal cord injury (SCI) often have detrusor overactivity in combination with detrusor-sphincter dyssynergia.[1]This pathological condition results in urological complications, for example, bladder deformity, a low bladder compliance and vesico-urethral reflux (VUR).[1]. It should be noted that CIC can still cause urethral trauma and genital infection.[5,6]
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