Sweetser P M, Badell A, Schneider S, Badlani G H
Department of Urology, Long Island Jewish Medical Center, New Hyde Park, NY 11040-1496, USA.
Neurourol Urodyn. 1995;14(1):57-64. doi: 10.1002/nau.1930140110.
A newly revised operation for controlling spasticity in cerebral palsy patients, selective dorsal rhizotomy (SDR), has the potential to affect bladder function. The goal of this multidisciplinary study is to investigate the potential change in bladder function by characterizing and comparing pre- and post-operative symptoms and bladder function, both qualitatively and quantitatively, in 34 pediatric patients over the age of three with spastic cerebral palsy as the indication for selective dorsal rhizotomy. Video urodynamics were performed in a subset of patients. Almost all patients with quadriplegia were incontinent (8/9) and none were significantly helped with bladder control. Almost half (5/11) of patients with diplegia who failed prior bladder control training were able to gain continence post-operatively. No patient experienced permanent damage to the function of their bladder. In conclusion, selective dorsal rhizotomy using the revised technique of Peacock [Peacock et al. (1987): Pediatr Neurosci 13:61-66.] appears to be safe for spastic cerebral palsy patients' bladder function. It can help decrease symptoms and improve bladder capacity and control in almost half of those symptomatic cerebral palsy patients with diplegia.
一种新修订的用于控制脑瘫患者痉挛状态的手术——选择性背根切断术（SDR），有可能影响膀胱功能。这项多学科研究的目的是，通过定性和定量地描述和比较34名年龄超过三岁的痉挛性脑瘫患儿在选择性背根切断术前、后的症状及膀胱功能，来研究膀胱功能的潜在变化，这些患儿因痉挛性脑瘫而接受选择性背根切断术。对部分患者进行了影像尿动力学检查。几乎所有四肢瘫痪的患者都有尿失禁（9例中的8例），并且膀胱控制能力均未得到显著改善。之前膀胱控制训练失败的双瘫患者中，近一半（11例中的5例）术后能够实现控尿。没有患者出现膀胱功能的永久性损伤。总之，采用皮科克[皮科克等人（1987年）：《儿科神经科学》13：61 - 66]修订技术的选择性背根切断术，对于痉挛性脑瘫患者的膀胱功能似乎是安全的。它可以帮助减轻症状，并使近一半有症状的双瘫脑瘫患者的膀胱容量和控制能力得到改善。
