Disruption of sensation-dependent bladder emptying due to bladder overdistension in a complete spinal cord injury:A case report  

作　　者：Ju-Yul Yoon Da-Sol Kim Gi-Wook Kim Yu Hui Won Sung-Hee Park Myoung-Hwan Ko Jeong-Hwan Seo 

机构地区：[1]Department of Physical Medicine and Rehabilitation,Jeonbuk National University Medical School,Jeonju 54097,Jeonbuk,South Korea [2]Department of Physical Medicine and Rehabilitation,Jeonbuk National University Medical School,Korea Research Institute of Clinical Medicine of Jeonbuk National University−Biomedical Research Institute of Jeonbuk National University Hospital,Jeonju 54097,Jeonbuk,South Korea

出　　处：《World Journal of Clinical Cases》2021年第29期8946-8952,共7页世界临床病例杂志

摘　　要：BACKGROUNDAutonomic dysreflexia (AD) can be a life-threatening condition in patients withspinal cord injury. It is important to prevent bladder overdistension in thesepatients as it may trigger AD. Sensation-dependent bladder emptying (SDBE), asa method of bladder management, improves the quality of life and allowsphysiologic voiding. In this study, we report disruption of the SDBE habit afterbladder overdistension leading to AD with chest pain.CASE SUMMARYA 47-year-old male with a diagnosis of C4 American Spinal Cord InjuryAssociation impairment scale A had been emptying his bladder using the cleanintermittent catheterization method with an itchy sensation in the nose as asensory indication for a full bladder for 23 years, and the usual urine volume wasabout 300-400 mL. At the time of this study, the patient had delayed catheterizationfor approximately five hours. He developed severe abdominal pain andheadache and had to visit the emergency room for bladder overdistension (800mL) and a high systolic blood pressure (205 mmHg). After control of AD, ahypersensitive bladder was observed despite using anticholinergic agents. Thesensation indicating bladder fullness changed from nose itching to pain in theabdomen and precordial area. Moreover, the volume of the painful bladder fillingsensation became highly variable and was noted when the bladder urine volumeexceeded only 100 mL. The patient refused intermittent clean catheterization Finally, a cystostomy was performed, which relieved the symptoms.CONCLUSIONPatients using physiologic feedback, such as SDBE, for bladder management arerecommended to avoid bladder overdistension.

关 键 词：Neurogenic bladder Sensation-dependent bladder emptying Spinal cord injury Autonomic dysreflexia Bladder overdistension Bladder management Case report 

分 类 号：R694[医药卫生—泌尿科学] R651.2[医药卫生—外科学]