Posted by Marty on June 23, 1999 at 12:25:18
I have a
neurogenicNeurogenic bladder bladder with DESD due to a t-12 injury. I have tried
both
DitropanDitropan
Ditropan xl and
DetrolDetrol
Detrol la to reduce my bladder
spasmsCoronary artery spasm
Croup
Eyelid twitch
Facial tics
Hand or foot spasms
Urge incontinence
Vascular spasm and increase capacity;
neither drug has worked. Recently I was advised by a urologist who specializes
in
neurogenicNeurogenic bladder bladders to undergo a procedure in which
capsaicinCapsaicin
Capsaicin topical is injected
into my bladder. I have been told that this procedure should lessen the spasms
and increase capacity. What is your opinion on capsaicin? How safe? How
effective? How long do the effects generally last?
Thanks for your opinion,
It is greatly appreciated!
Posted by HFHS M.D.-AK on June 24, 1999 at 13:37:04
Dear Marty,
I have personally never used Capsaicin to treat a patient but have read about it in the literature. Capsaicin decreases the afferent input peripherally which would be the ideal type treatment for your problem. This compound helps treat sensory urgency, bladder instability, and in your case, hyperreflexia. Capsaicin is an irritant and algogenic compound obtained from hot red peppers. It has highly selective effects on a subset of mammalian sensory neurons. Local or topical administration of this compound blocks C-fiber conduction(Sensory fibers) thereby reducing perceived pain and inflammation. Intravesical administration carries all the advantages of therapy without the potential systemic side effects. After therapy, there is immediate suprapubic burning for 10 minutes. The systemic symptoms begin to disappear on day 2-3 and remain completely treated for up to 3 weeks. At this point, the symptoms gradually reappear but never reach the level of the initial problem. Also, the bladder capacity increases and decreases frequency of urination.
I think the treatment itself is very safe, and there should be no long-term side effects. You will have to have a catheter inserted into the bladder potentially introducing an infection. Again I don’t have any experience with this medication. I have asked several of my colleagues to see if they have used it and they have not. If you are being treated by an expert in the voiding dysfunction field of urology you should ask them these same questions.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-AK
*keyword:Bladder Hyperrefexia