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Journal of the Korean Academy of Rehabilitation Medicine 2003;27(3):344-348.
Stretching Therapy of Neurogenic Bladder in Patients with Spinal Cord Injury.
Shin, Ji Cheol , Park, Chang Il , Kim, Yong Wook , Park, Sa Yun , Rha, Dong Wook , Kim, Jung Eun
1Department of Rehabilitation Medicine, Yonsei University College of Medicine, Korea. deerpsy@medimail.co.kr
2Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Korea.
척수 손상 환자의 신경인성 방광에서 방광 신장 치료법
신지철, 박창일, 김용욱, 박사윤, 나동욱, 김정은
연세대학교 의과대학 재활의학교실 및 재활의학연구소
Abstract
Objective
To evaluate the effect of stretching therapy of neurogenic bladder in spinal cord injured patients.


Method
Twelve spinal cord injured patients who had neurogeic bladder manifested with urinary incontinence resistant to oral and intravesical anticholinergic instillation treatment were selected. Oxybutynin solution was instillated via foley catheter and the catheter was clamped until incontinence occur. This was performed twice a day for 7 days. The urodynamic studies were compared before and after therapy. Total volume of daily incontinence and total volume of daily fluid intake were also monitored.


Results
After stretching therapy, median maximal bladder capacity increased from 190.08 to 457.17 ml (p<0.01), mean bladder compliance increased from 8.46 to 18.85 ml/cmH2O (p<0.01), mean reflex volume increased from 148.75 to 252.17 ml (p<0.05), mean maximal detrusor pressure decreased from 52.17 to 28.29 cmH2O (p<0.01), mean clinical maximal capacity increased from 277.50 to 537.50 ml (p<0.01), and mean daily incontinent volume decreased from 508.33 ml to 20.83 ml (p<0.01). No significant correlation was found between the duration since onset of injury and the urodynamic finding.


Conclusion
This study proved that stretching therapy of bladder was an effective method in spinal cord injured patients who had neurogenic bladder with uncontrolled incontinence with conventional therapy. (J Korean Acad Rehab Med 2003; 27: 344-348)

Key Words: Spinal cord injury, Neurogenic baldder, Intravesical instillation, Stretching therapy


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