Hackler R H, Broecker B H, Klein F A, Brady S M
J Urol. 1980 Jul;124(1):78-81. doi: 10.1016/s0022-5347(17)55305-7.
Significant bladder residual urine is secondary to pelvic floor skeletal muscle hypertonicity in some spinal cord injury patients with suprasacral or mixed lesions. Fifteen patients with residual urine volumes greater than 150 cc were treated with dantrolene sodium because of its ability to decrease skeletal muscle contractibility. All of the patients had urethral closure pressures greater than 100 cm. water. Of the 15 patients 8 benefited from dantrolene sodium therapy and were maintained on external condom urinary drainage. Five of these 8 patients required up to 600 mg. dantrolene sodium daily to affect this result. The residual urine volume decreased to less than 100 cc and the post-therapy decrease in urethral pressure averaged 77 cm. water (49 per cent). The patients in the failure group (residual urine greater than 150 cc) had an average decrease in urethral pressure of 21 cm. water (16 per cent). Detrusor hyporeflexia possibly contributed to the failure rate. In summary, dantrolene sodium seems to be beneficial in some patients with external urinary sphincter hypertonicity. However, it will not supplant external sphincterotomy in the more complete male spinal cord injury patient in whom reflex incontinence is of minimal concern. Dantrolene sodium could be an ideal treatment of patients with incomplete neurologic lesions in whom continence might be preserved. The drug will have to be effective at low doses to obviate the major side effect of over-all muscle weakness.
在一些骶上或混合型脊髓损伤患者中，显著的膀胱残余尿量继发于盆底骨骼肌张力亢进。15例残余尿量超过150cc的患者接受了丹曲林钠治疗，因为它能够降低骨骼肌的收缩性。所有患者的尿道闭合压均大于100cm水柱。15例患者中，8例从丹曲林钠治疗中获益，并维持使用外部避孕套式尿引流。这8例患者中有5例每天需要高达600mg的丹曲林钠才能达到这一效果。残余尿量降至100cc以下，治疗后尿道压力平均下降77cm水柱（49%）。失败组（残余尿量大于150cc）的患者尿道压力平均下降21cm水柱（16%）。逼尿肌反射减退可能是导致失败率的原因。总之，丹曲林钠似乎对一些尿道外括约肌张力亢进的患者有益。然而，对于反射性尿失禁不太严重的完全性男性脊髓损伤患者，它并不能取代尿道外括约肌切开术。丹曲林钠可能是治疗不完全性神经损伤且可能保留控尿能力患者的理想药物。该药物必须在低剂量时有效，以避免总体肌肉无力这一主要副作用。
