报道肖的"Nature Clinical Practice Urology" 的全文,



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送交者: 注笔名册 于 2005-11-08, 15:02:09:

俺ILL 的是印刷的, 只能先手工输入了, 等找到扫描仪再上IMAGE 吧.

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Surgical alternative for voiding dysfunction in spina bifida

A novel surgical procedure for children suffering from neurogenic voiding dysfunction caused by spina bifida was recently reported by a team of researchers based in China and the US. The same team had previously successfully demonstrated the procedure in patients with spinal-cord injury.

Xiao and colleagues caried out a limited laminectomy and lumbar ventral root to S3 ventral root microanastomosis in 20 children (mean age 11 years) with spina bifida and nuerogenic bladder. All children were incontinent before surgery. They also undertook a preoperative urodynamic evaluation, which revealed that
the patients had one of two types of nuerogenic bladder-areflexic, or hyperreflexic with detrusor-external-sphincter dyssynergia. An urodynamic assessment was also carried out after surgery in order to assess the outcomes of the procedure.

the surgical result was an artificial somatic-autonomic refles pathway, which, in 17 out of 20 patients, led to them gaining acceptable bladder control and continence within 1 year, and in some cases as early as 6 months. Interestingly, the authors found that the 17 children also gained bladder sensory function. Following surgery, 12 of the 14 patients with areflexic bladders showed an increased mean bladder capacity and decreased post-void residual urine, and 5 out of 6 patients with hyperreflexic bladder gained continence.

The authors conclude that the artificial somatic-autonomic reflex pathway prodedure is safe and effective, and allows children with spina bifida to gain bladder control and voluntary voiding.

Original article Xiao CG et al. (2005) An artificial somatic-autonomic reflex pathway
procedure for bladder control in children with spina bifida. J Urol 173:2112-2116




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