Bladder-pumping therapy for the treatment of low-capacity or low-compliance bladders.
The walls of low-capacity or low-compliance bladders are thought to be less elastic than normal. Pumping of the bladder was found to disrupt collagen-fiber bundles in the rat bladder wall, offering the promise of potential clinical application. This result prompted us to use bladder-pumping therapy to soften the bladder wall in patients with low-capacity or low-compliance bladders to restore bladder elasticity. CO(2) gas or air, at a volume below the maximum bladder capacity (</=200 mL), was repeatedly pumped in and out of the bladder through a catheter under caudal anesthesia in 26 patients with low-capacity or low-compliance bladders and without uninhibited bladder contractions, who presented with urinary frequency or incontinence. A respirator was used to control the pumping at 0.5 cycles/s for a duration of 15 minutes. No serious adverse effects were encountered during or after the procedure. Overall subjective improvement was noted 4 weeks after the procedure in 11 of 18 patients with a low capacity bladder (<300 mL) and in five of eight patients with a low-compliance bladder (<20 mL/cm H(2)O). The procedure significantly increased the maximum bladder capacity, single voided volume, and average urinary flow rate after 4 weeks. In the responding patients, subjective improvement lasted from 3 months to over 6 years. Bladder-pumping therapy is an easy and safe procedure and exerts a beneficial effect for a long period, in patients with low-capacity or low-compliance bladders and without uninhibited bladder contractions. Neurourol. Urodynam. 19:19-28, 2000.
Sugaya
K
K
Department of Urology, University of the Ryukyus, Okinawa, Japan. sugaya@med.u-ryukyu.ac.jp
Nishizawa
O
O
Satoh
T
T
Hatano
T
T
Ogawa
Y
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D000388:Air; D002245:Carbon Dioxide / Q000008:administration & dosage / Q000627:therapeutic use; D002404:Catheterization; D003187:Compliance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013594:Syringes; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000503:physiopathology*; D001745:Urinary Bladder Diseases / Q000150:complications / Q000503:physiopathology* / Q000628:therapy*; D014549:Urinary Incontinence / Q000209:etiology; D014555:Urination Disorders / Q000209:etiology
D002245:Carbon Dioxide