Title
What are the causes and consequences of bladder overdistension? ICI-RS 2011What are the causes and consequences of bladder overdistension? ICI-RS 2011
Author
Faculty/Department
Faculty of Medicine and Health Sciences
Research group
Translational Neurosciences (TNW)
Publication type
article
Publication
New York,
Subject
Human medicine
Source (journal)
Neurourology and urodynamics. - New York
Volume/pages
31(2012):3, p. 317-321
ISSN
0733-2467
ISI
000301577900006
Carrier
E
Target language
English (eng)
Full text (Publishers DOI)
Affiliation
University of Antwerp
Abstract
Aims To report the outcome of the think tank on prolonged bladder overdistension from the 3rd ICI-RS meeting. Methods: Prolonged bladder overdistension was discussed after acute urinary retention, its terminology, its prevalence, pathophysiology, and consequences, as well as prophylactic and therapeutic aspects. Results: Acute prolonged bladder overdistension (ApBO) is a consequence of undetected or inadequately treated acute retention, and is mostly due to regional anesthesia, prolonged childbirth, or extensive surgery. Currently, there is no agreed terminology. A primary, temporary neurogenic detrusor dysfunction causing retention is associated with decreased or absent bladder sensation therefore patients do not complain, and management is delayed. Therapeutically, the first intervention is to drain the bladder. Recovery depends on whether reversible or irreversible damage has occurred. There are no good data to support the use of drugs or sacral neuromodulation. Intravesical electrostimulation is the only treatment that has specifically addressed this problem with encouraging results. There are no recent reports on the effect of surgery for myogenic bladder damage. Conclusion: ApBO is an important, but often unrecognized medical complication. There is a need for defining the terminology, for studies to record the incidence of different types of bladder overdistension, and to establish management strategies. Apart from clean intermittent self catheterizaiton (CIC) there are no data justifying pharmacological or other therapies. Therefore, prevention is of paramount importance and there is a need to develop and test preventative strategies, which should then be incorporated in surgical registries. Neurourol. Urodynam. 31:317-321, 2012. (C) 2012 Wiley Periodicals, Inc.
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