PDF(Pubmed)
Abstract：
Neurogenic bladder (NB) is a frequently encountered post-stroke complication, characterized by symptoms, such as urinary incontinence, dysuria, increased frequency, and urgency. Here, we present a case of a 75-year-old male with urgent urination, frequent urination, urinary incontinence, conspicuous discomfort during urination, and an unpleasant smell in the urine following a stroke. By reviewing the patient\'s previous medical records of stroke and ruling out other potential causes for bladder dysfunction, a diagnosis of NB could be established. We implemented conventional physical therapy, pelvic floor muscle training with the electromyography biofeedback device, and continuous theta burst stimulation (cTBS) on the contralesional primary motor cortex area to manage bladder function. To the best of our knowledge, this is the first case report on cTBS applied to manage NB after stroke. Our treatment has demonstrated remarkable efficacy in enhancing bladder and kidney function, improving the overall quality of life, and alleviating anxiety and depression symptoms in this patient. This case study concludes that the noninvasive neuromodulation approach exhibits significant potential in the clinical field when addressing this specific patient population.
摘要：
神经源性膀胱（NB）是中风后经常遇到的并发症，以症状为特征，如尿失禁，排尿困难,频率增加，和紧迫性。这里,我们介绍了一例75岁男性尿急,尿频,尿失禁,排尿时明显不适，中风后尿液中有难闻的气味。通过回顾患者以前的中风病历，排除膀胱功能障碍的其他潜在原因，可以建立NB的诊断。我们实施了传统的物理治疗，使用肌电图生物反馈装置进行盆底肌肉训练，和对对比区初级运动皮质区域的连续theta爆发刺激（cTBS）来管理膀胱功能。据我们所知,这是cTBS应用于卒中后NB管理的首例病例报告.我们的治疗在增强膀胱和肾功能方面表现出显著疗效，提高整体生活质量，并减轻该患者的焦虑和抑郁症状。本案例研究得出的结论是，当解决该特定患者群体时，非侵入性神经调节方法在临床领域显示出巨大的潜力。
