慢性脊髓损伤患者神经源性下尿路功能障碍的介入治疗和手术:泌尿科医生的观点

IF 1.5 4区 医学 Q3 UROLOGY & NEPHROLOGY
Sheng-Fu Chen, Hann-Chorng Kuo
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引用次数: 4

摘要

脊髓损伤引起的神经源性下尿路功能障碍(NLUTD)是泌尿科医生面临的一个挑战。NLUTD不仅影响生活质量,而且危及慢性脊髓损伤患者的上尿路。考虑到膀胱和尿道功能随时间的变化,定期随访是必要的,任何并发症都应得到充分的治疗。对于表现为NLUTD的慢性脊髓损伤患者,膀胱管理的首要任务应该是保持肾功能,其次是使下尿路功能正常化。生活质量也应该得到评估。对于肾功能受损风险较高的患者,应更频繁地进行识别和检查。应尽早开始保守治疗和药物治疗。膀胱内或尿道内注射肉毒杆菌毒素A是难治性NLUTD的另一种治疗方法。当需要手术干预时,应首先考虑侵入性较小且可逆的手术。改善患者的生活质量和接受膀胱管理的意愿是治疗的最重要方面。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Interventional management and surgery of neurogenic lower urinary tract dysfunction in patients with chronic spinal cord injury: A urologist's perspective

Neurogenic lower urinary tract dysfunction (NLUTD) caused by spinal cord injury (SCI) is challenging for urologists. NLUTD not only affects the quality of life but also endangers the upper urinary tract of patients with chronic SCI. Considering that the bladder and urethral function change with time, regular follow-up of NLUTD is necessary, and any complication should be adequately treated. The first priority of bladder management in patients with chronic SCI manifesting NLUTD should be renal function preservation, followed by the normalization of lower urinary tract function. The quality of life should also be assessed. Patients who have a high risk for impaired renal function should be more frequently identified and investigated. Conservative treatment and pharmacological therapy should be started as early as possible. Intravesical or urethral injections of botulinum toxin A is an alternative treatment for refractory NLUTD. When surgical intervention is necessary, less invasive and reversible procedures should be considered first. Improving patients' quality of life and willingness to undergo bladder management is the most important aspect of treatment.

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来源期刊
LUTS: Lower Urinary Tract Symptoms
LUTS: Lower Urinary Tract Symptoms UROLOGY & NEPHROLOGY-
CiteScore
3.00
自引率
7.70%
发文量
52
审稿时长
>12 weeks
期刊介绍: LUTS is designed for the timely communication of peer-reviewed studies which provides new clinical and basic science information to physicians and researchers in the field of neurourology, urodynamics and urogynecology. Contributions are reviewed and selected by a group of distinguished referees from around the world, some of whom constitute the journal''s Editorial Board. The journal covers both basic and clinical research on lower urinary tract dysfunctions (LUTD), such as overactive bladder (OAB), detrusor underactivity, benign prostatic hyperplasia (BPH), bladder outlet obstruction (BOO), urinary incontinence, pelvic organ prolapse (POP), painful bladder syndrome (PBS), as well as on other relevant conditions. Case reports are published only if new findings are provided. LUTS is an official journal of the Japanese Continence Society, the Korean Continence Society, and the Taiwanese Continence Society. Submission of papers from all countries are welcome. LUTS has been accepted into Science Citation Index Expanded (SCIE) with a 2011 Impact Factor.
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