Resumo

LOPEZ CARBALLO, C. et al. Continuous lumbar epidural uncontrollable bladder spasms. Rev. Soc. Esp. Dolor [online]. 2013, vol.20, n.2, pp.45-49. ISSN 1134-8046.  https://dx.doi.org/10.4321/S1134-80462013000200002.

We present a clinical case of bladder spasms due to detrusor overactitivity, triggered by continuous vesicoclysis therapy, which was applied in a patient with benign prostatic hypertrophy-related hematuria. Bladder spasms turned out to be refractory to combined antimuscarinic, spasmolytic and systemic opioid therapies. Implantation of a lumbar epidural catheter was chosen for continuous epidural infusion of local anesthetics and opioid drugs as an alternate analgesic therapy, which provided the patient an optimum comfort, but let urethral indwelling catheterization and the maintenance of continuous vesicoclysis therapy as well. We reviewed scientific literature concerning bladder-afferent neurotransmission blockade at epidural level for dysfunctional bladder pain therapy, and discussed several published theories about pain physiopathology and origin in those cases of dysfunctional bladder disturbance, with the aim to interpret the peculiarity and complexity of the described clinical case.

Palavras-chave : Blockade at epidural level; Dysfunctional bladder; Pain bladder; Overactive bladder syndrome; Neuromodulation.

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