CURRENT MANAGEMENT OF ADULT NEUROGENIC BLADDER – A REVIEW
Authors:
H. Tunuguntla; Y. Suk Kwon
Authors‘ workplace:
Section of Voiding Dysfunction, Neuro-Urology, Female Pelvic Medicine and Reconstructive Surgery, and Urodynamics
; Rutgers, the State University of New Jersey, Robert Wood Johnson Medical School
; Division of Urological Surgery
Published in:
Urol List 2015; 13(3): 14-21
Overview
In this review, the authors sought to present different patterns of voiding abnormalities and conventional and emerging treatment options in order to provide timely information for urologists who seek to optimize their care for patients with neurogenic lower urinary tract dysfunction. Management options of proven benefit in neurogenic lower urinary tract dysfunction are not uniformly utilized effectively. As significant and rapid advances in therapy have been made in the field of urodynamics in the past two decades, it is becoming increasingly important for clinicians to gain a deeper understanding of complex disease mechanisms associated with neurogenic lower urinary tract dysfunction and to develop appropriate treatment strategies accordingly. Adult neurogenic lower urinary tract dysfunction is a very common urological condition affecting men and women worldwide occurring in patients with central, peripheral, autonomic or mixed neurological conditions. In this up to date treatise, basic and urodynamic evaluation of patients with various neurogenic lower urinary tract conditions is discussed along with non-pharmacological, pharmacological, minimally invasive, and reconstructive surgical treatment options. Lower urinary tract dysfunction in common neurogenic problems including cerebrovascular accidents, Parkinson‘s disease, multiple sclerosis, brain tumors, spinal cord injury, myelodysplasia, spinal cord tumors, herniated intervertebral disk, peripheral nerve injury, cauda equina syndrome, conus medullaris syndrome, among others are discussed. Contemporary advances in the management of adult neurogenic lower urinary tract dysfunction as practiced in academic centers worldwide in 2015 have been presented in this review. Current emphasis on the practical and clinical classification of neurogenic lower urinary tract dysfunction into a low and high risk category and utilization of such categorization in the management of patients with neurogenic lower urinary tract dysfunction has been discussed. Regular and lifelong urological follow up can preserve the upper urinary tract, improve the outcomes, prevent complications, and potentially result in an optimized quality of life and life expectancy.
Key words:
spinal cord injuryneurogenic bladderdetrusor sphincter dyssynergianeurogenic lower urinary tract dysfunctionurodynamicsvoiding dysfunction
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