Intrathecal clonidine for refractory detrusor hyperreflexia in spinal cord injured patients: a preliminary report.

Abstract

We assessed the urodynamic effect of various doses of intrathecal clonidine on refractory detrusor hyperreflexia in spinal cord injured patients. Doses of 15, 30 or 45 microg. intrathecal clonidine or placebo were given to 5 chronic complete spinal cord injured patients with detrusor hyperreflexia. Two cystometries were performed before and 5, 30, 60, 90, 120 and 180 minutes after each injection. A statistically significant dose dependent decrease in detrusor hyperreflexia was observed in each patient without significant side effect. Intrathecal clonidine may represent a conservative reversible treatment for detrusor hyperreflexia via a subcutaneous programmable pump, like that used for baclofen, for spasticity. The long-term efficacy needs to be evaluated.