Voiding Dysfunction: Diagnosis and Treatment

340 Pages·2000·7.67 MB·English

by  Alan J. Wein MD

VOIDING DYSFUNCTION
CURRENT CLINlCAL UROLOGY
Eric A. Klein,
SERIES EDITOR
Voiding Dysfunction: Diagnosis and Treatment, edited by Rodney A.
Appell, 2000
Management ofP rostate Cancer, edited by Eric A. Klein, 2000
VOIDING
DYSFUNCTION
DIA
GNOSIS
AND
TREATMENT
Edited by
RODNEY A. ApPELL, MD
Cleveland Clinic Fountkttion,
Cleveland, OH
HUMANA PRESS
TOTOWA, NEW JERSEY
© 2000 Humana Press Inc.
Softcover reprint ofthe hardcover 1st edition 2000
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Voiding dysfunction : diagnosis and treatment/edited by Rodney A. Appell
p. ; cm.---(Current clinical urology)
Includes bibliographical references and index.
ISBN 978-1-4684-9689-5 ISBN 978-1-59259-198-5 (eBook)
DOI 10.1007/978-1-59259-198-5
I. Urination disorders. I. Appell, Rodney A. 11. Series.
[DNLM: I. Urination Disorders---diagnosis. 2. Urination Disorders-therapy. WJ 146
V8892000]
RC901.75.V652000
616.6'2---dc21
DNLM/DLC 00-027599
for Library of Congress CIP
PREFACE
The purpose of Voiding Dysfunction: Diagnosis and Treatment is to bring the
reader up to date on all clinical aspects of voiding dysfunction, not just
urodynamic and other evaluative techniques, but varying nuances in presenta
tion ofthe individual problems that may occur during voiding, sometimes as a
manifestation of an underlying disease or disorder, and at other times because
of indi vidual patient circumstances, including the patient' s beha vior or the effects
of treatment for an unrelated disorder. Voiding dysfunction includes disorders
ofurinary storage as well as the emptying ofthe lower urinary tract. Although
urinary incontinence is a huge problem worldwide as exemplified by the abso
lute need ofthe World Health Organization (WHO) to sponsor the mammoth
undertaking of an international consultation on the topic in mid-1998, other
voiding disorders also adversely affect the quality ofthe lives ofthe individuals
afflicted. These problems are often placed on the "back burner" with respect to
basic and clinical research because they do not result in death; however, it is
important to recognize that the quality of one's life is as important as me re
existence itself, as demonstrated by the extent to which people will go to try
therapies (many unproven) at tremendous expense to make small improvements
in the quality of their respective lives.
Fortunately, knowledge of lower urinary tract function and dysfunction has
advanced rapidly over the last half of the 20th century from the early phase of
urodynamics (a term first used in 1953 by D. M. Davis [1]) to the current neu
rological era (2).
I want to express my appreciation to an excellent group of contributors to
Voiding Dysfunction: Diagnosis and Treatment for their timely response to my
request to put down on paper, in an explicable mann er, the current states ofthe
art and science of voiding dysfunction. First, there is a presentation on the
current background information necessary, to understand the physiology ofthe
normallower urinary tract and how to use that information to classify the various
voiding dysfunctions. This is followed by an overview ofthe manner in which
voiding dysfunction is diagnosed, stressing the importance of individualizing
the evaluation to demonstrate the voiding dysfuction. Following this, there is a
comprehensive discussion ofmajor neurological problems and their adverse ef
fects on voiding function. This section includes discussions of specific diseases
v
VI Preface
and disorders that make up the so-called "neurogenic bladder," which is, quite
obviously, not a single entity. Individual discussions include the effects ofstroke,
multiple sclerosis, spinal cord problems, diabetes mellitus, and lumbar disc
disorders on lower urinary tract function. The next section involves dysfunction
in individual patients only, with comprehensive reviews of urinary incontinence
and urinary retention. Attention in the following section revolves around voiding
dysfunctions unique to males: bladder outlet obstruction and postprostatectomy
incontinence. The final segment covers general topics involved in newer modali
ties oftreatment for voiding dysfunction and includes pharmacologic therapy,
electrical stimulation, and surgery for intractable instability-augmentation
cytoplasty.
I am certain readers will find Voiding Dysfunction: Diagnosis and Treatment
informative, practical, and clinically relevant.
Rodney A. Appell, MD
References
l. Davis, D. M. (1953) The mechanisms of urologie disease. WB Saunders,
Philadelphia.
2. Hinman, F., Jr. (1996) Urodynamics I: Foreword. Ural. Clin. N. Amer. 23, xi-xii.
CONTENTS
Preface ......................................................................................... v
List of Contributors ................................................................... .ix
Part I. Introduction
1 Pathophysiology and Classification
of Voiding Dysfunction ..................................................... 3
Alan J. Wein and Eric S. Rovner
2 Voiding Dysfunction: Diagnostic Evaluation ....................... 25
Victor W. Nitti and Michael Ficazzola
Part 11. Neurogenie Vesico-Urethral Dysfunction
3 Cerebrovascular Accidents ................................................ 63
Serge Peter Marinkovic and Gopal H.Badlani
4 Multiple Sclerosis ............................................................... 83
Jerry G. Blaivas
5 Diagnosis and Treatment of Spinal Cord Injuries
and Myeloneuropathie ................................................. 115
Steven W. Sukin and Timothy B. Boone
6 Diabetic Bladder Dysfunction ............................................ 139
Howard B. Goldman and Rodney A. Appell
7 Lumbar Disc Disease ....................................................... 149
Howard B. Goldman and Rodney A. Appell
Part 111. Female Voiding Dysfunction
8 Treatment of Stress Urinary Incontinence ........................ 163
Raymond Rackley
9 Urinary Retention in Women ............................................ 185
Roger R. Dmochowski
Part IV. Male Voiding Dysfunction
10 Bladder Outlet Obstruction in Males ................................. 225
Edward F. Ikeguchi, Alexis E. Te, James Choi,
and Steven A. Kaplan
Vll
Vlll Contents
11 Post-Prostatectomy Incontinence ..................................... 247
Harriette M. Searpero and J. Christian Winters
Part V. Treatment Modalities
12 Clinical Pharmacology ..................................................... 275
Seott R. Serels and Rodney A. Appell
13 Treatment of Detrusor Instability
with Electrical Stimulation ............................................ 297
Steven W. Siegel
14 Treatment of Detrusor Instability
with Augmentation Cystoplasty ........................................ 315
Joseph M. Khoury
Index ......................................................................................3 26
CONTRIBUTORS
RODNEY A. ApPELL, MD • Seetion of Voiding Dysfunetion and Female Urology,
Department of Urology, Cleveland Clinie Foundation, Cleveland, OH
GOPAL H. BADLANI, MD • Department of Urology, Long lsland Jewish Medieal
Center, New Hyde Park, NY
JERRY G. BLAIVAS, MD • Urologie Oneology, New York Hospital-Cornell
Medieal Center, New York, NY
TIMOTHY B. BOONE, MD, PHD • Seott Department ~f Urology, Baylor College
ofM edicine, Houston, TX
JAMES CHOI, MD· Department ~fUrology, Columbia University Medieal Center,
New York, NY
ROGER R. DMOCHOWSKI, MD, FACS • North Texas Center/ar UrinarJ' Control,
Fort Worth, TX
MICHAEL FICAZZOLA, MD • Department ~f Urology. New York University Medieal
Center, New York, NY
HOWARD B. GOLDMAN, MD • Department ofUrology, Case Western Reserve
University, Cleveland, OH
EDWARD F. IKEGUCHI, MD· Department ofUrology, Columbia University
Medieal Center, New York, NY
STEVEN A. KAPLAN, MD • Department of Urology, Columbia University
Medieal Center, New York, NY
JOSEPH M. KHOURY, MD, SCD· Division ofUrology, University ofNorth Carolina
Medieal Center, Chapel Hili, NC
SERGE PETER MARINKOVIC, MD • Department of Urology, Long lsland Jewish
Medieal Center, New Hyde Park, NY
VICTOR W. NITTI, MD • Department of Urology, New York University Medical
Center, New York, NY
RA YMOND RACKLEY, MD • Seetion of Voiding Dysfunetion, Department
of Urology, Cleveland Clinie Foundation, Cleveland, OH
ERIC S. ROVNER, MD • Division of Urology, Hospital of the University
of Pennsylvania, University of Pennsylvania Sehool of Medicine,
Philadelphia, PA
HARRlETTE M. SCARPERO, MD • Department of Urology, Ochsner Clinic,
Louisiana State University Health Sciences Center, New Orleans, LA
ix
x Contributors
SCOTT R. SERELS, MD' Bladder Control Center, Urology Association ofNorwalk,
No rwalk, cr
STEVEN W. SIEGEL, MD • Metropolitan Neurologie Specialists, St. Paul, MN
STEVEN W. SUKIN, MD • Seott Department 0/ Urology, Baylor College
0/ Medieine, Houston, rx
ALEXIS E. TE, MD • Department 0/ Urology, Columbia University Medieal
Center, New York, NY
ALAN 1. WEIN, PHD • Division 0/ Urology, Hospital 0/ the University
0/ Pennsylvania, University 0/ Pennsylvania Sehool 0/ Medieine,
Philadelphia, PA
1. CHRISTIAN WINTERS, MD • Department 0/ Urology. Oehsner Clinie, Louisiana
State University Health Seiences Center, New Orleans, LA