Skip to main content
SpringerLink
Log in

Intrathecal baclofen infusion in patients with spasticity and neurogenic bladder disease

Preliminary results

  • Free Paper
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Summary

Nine severely spastic men suffering from neurogenic bladder disease resulting from spinal cord lesion or multiple sclerosis were treated with continuous intrathecal infusion of baclofen using an implanted programmable pump. Bladder function improved in all patients; significant improvements consisted of an increase in bladder capacity, a decrease in residual volume, and diminished pelvic-floor spasm. Three subjects became continent. Intermittent self-catheterization was no longer impeded by adductor spasm. In three patients complete bladder emptying could be achieved. In two cases maximal bladder pressure diminished; in two others it increased, but for the whole group the changes were not significant.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. De Groat WC (1970) The actions of GABA and related amino acids on mammalian autonomic ganglia. J Pharmacol Exp Ther 172:384–396

    Google Scholar 

  2. De Groat WC (1986) Spinal cord projections and neuropeptides in visceral afferent neurons. In: Cervero F, Morrison JFB (eds) Visceral sensation. (Progress in brain research, vol 67) Elsevier, Amsterdam, pp 165–187

    Google Scholar 

  3. Faigle JW, Keberle H (1972) The chemistry and kinetics of Lioresal. Postgrad Med J 48 [Suppl]:9–13

    Google Scholar 

  4. Leyson JFJ, Martin BF, Sporer A (1980) Baclofen in the treatment of detrusor sphincter dyssynergia in spinal cord injury patients. J Urol 124:82–84

    Google Scholar 

  5. Kieswetter H, Schober W (1975) Lioresal in the treatment of neurogenic bladder dysfunction. Urol Int 30:63–71

    Google Scholar 

  6. Kontani H, Kawabata Y, Koshiura R (1988) The effect of baclofen on the urinary bladder contraction accompanying micturition in anesthetized rats. Jpn J Pharmacol 46:7–15

    Google Scholar 

  7. Maggi CA, Santicioli P, Meli A (1985) GABA inhibits excitatory neurotransmission in rat pelvic ganglia. J Pharm Pharmacol 37:349–351

    Google Scholar 

  8. Maggi CA, Santicioli P, Guiliani S, Furio M, Conte B, Meli P, Gragnani L, Meli A (1987) The effects of baclofen on spinal and supraspinal micturition reflexes in rats. Naunyn-Schmiedeberg's Arch Pharmacol 336:197–203

    Google Scholar 

  9. Magora F, Shazar N, Drenger B (1989) Urodynamic studies after intrathecal administration of baclofen and morphine in dogs. J Urol 141:143–147

    Google Scholar 

  10. Milne RJ, Foreman RD, Giesler GJ, Willis WD (1981) Convergence of cutaneous and pelvic visceral nociceptive inputs onto primate spinothalamic neurons. Pain 11:163–183

    Google Scholar 

  11. Morrison JFB (1987) Bladder control: role of higher levels of the central nervous system. In: Torrens M, Morrison JBF (eds) The physiology of the lower urinary tract. Springer, Heidelberg New York Berlin, pp 237–274

    Google Scholar 

  12. Müller H, Zierski J, Dralle D, Borner U, Hoffmann O (1987) The effect of intrathecal baclofen on electrical muscle activity in spasticity. J Neurol 234:348–352

    Google Scholar 

  13. Müller H, Zierski J, Dralle D, Krauß D, Mutschler E (1988) Pharmacokinetics of intrathecal baclofen. In: Müller H, Zierski J, Penn RD (eds) Local-spinal therapy of spasticity. Springer, Heidelberg New York Berlin, pp 223–226

    Google Scholar 

  14. Nanninga JB, Frost F, Penn RD (1989) Effect of intrathecal baclofen on bladder and sphincter function. J Urol 142:101–105

    Google Scholar 

  15. Ochs G, Struppler A, Meyerson BA, Linderoth B, Gybels J, Gardner BP, Teddy P, Jamous A, Weinmann P (1989) Intrathecal baclofen for long-term treatment of spasticity: a multi-centre study. J Neurol Neurosurg Psychiatr 52:933–939

    Google Scholar 

  16. Penn RD, Savoy SM, Corcos D, Latash M, Gottlieb GG, Parke B, Kroin JS (1989) Intrathecal baclofen for severe spinal spasticity. N Engl J Med 320:1517–1521

    Google Scholar 

  17. Sillen U (1980) Central neurotransmitter mechanisms involved in the control of urinary bladder function. Scand J Urol Nephrol [Suppl] 58:1–45

    Google Scholar 

  18. Steers WD (1989) This month in investigative urology: intrathecal baclofen administration — insights into the regulation of genitourinary function and therapy editorial. J Urol 141:142

    Google Scholar 

  19. Torrens M (1987) Human physiology. In: Torrens M, Morrison JFB (eds) The physiology of the lower urinary tract. Springer, Heidelberg New York Berlin, pp 336–337

    Google Scholar 

  20. Wein AJ (1984) Pharmacology of the bladder and urethra. In: Mundy AR, Stephenson TP, Wein AJ (eds) Urodynamics. Churchill Livingstone, Edinburgh, pp 26–41

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology and Anesthesiology, Sophia Hospital, Dr. van Heesweg 2, NL-8025 AB, Zwolle, The Netherlands

    J. J. M. Kums & E. M. Delhaas

Authors
  1. J. J. M. Kums
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. E. M. Delhaas
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kums, J.J.M., Delhaas, E.M. Intrathecal baclofen infusion in patients with spasticity and neurogenic bladder disease. World J Urol 9, 99–104 (1991). https://doi.org/10.1007/BF00184041

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00184041

Keywords

Search

Navigation