Transient ischemic attack after electromotive drug administration for chronic non-infectious cystitis: report of two similar cases.
Electromotive drug administration (EMDA) is a new and promising approach for the treatment of chronic non-infectious cystitis. In animal studies utilizing EMDA there was evidence for deep penetration of dyes into the muscular layers of the bladder wall. However, besides minor local irritation no systemic side effects have been reported after translation of EMDA into the clinical setting.


OBJECTIVE
This article reports for the first time systemic neurological alterations after EMDA for chronic non-infectious cystitis.


METHODS
Two male patients, aged 72 and 78 years, respectively, were readmitted to the emergency room within few hours after EMDA showing clinical signs of transient ischemic attacks (TIA). After clinical examination, both patients were observed.


RESULTS
Under overnight observation without any specific therapy the symptoms vanished completely in both patients.


CONCLUSIONS
In older patients (>70 years of age) undergoing EMDA, cardiac and neurologic function should be monitored. The time of treatment during the first EMDA session should be limited to 15 or 20 min.
Hinkel
Andreas
A
Department of Urology and Neurourology, Ruhr-Universität Bochum, Marienhospital, Widumer Str. 8, Herne, Germany. andreas.hinkel@marienhospital-herne.de
Pannek
Jürgen
J
D000368:Aged; D002908:Chronic Disease; D003556:Cystitis / Q000188:drug therapy*; D003907:Dexamethasone / Q000008:administration & dosage*; D016503:Drug Delivery Systems; D004586:Electrophoresis; D004837:Epinephrine / Q000008:administration & dosage*; D006801:Humans; D007478:Iontophoresis / Q000009:adverse effects*; D002546:Ischemic Attack, Transient / Q000209:etiology*; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male
D003907:Dexamethasone; D008012:Lidocaine; D004837:Epinephrine