EAU Guidelines on Neurogenic Lower Urinary Tract Dysfunction

Stöhrer, M.; Blok, Bertil; Castro-Díaz, David; Chartier-Kästler, E.; Popolo, Giulio Del; Kramer, Guus; Pannek, Jürgen; Radziszewski, Piotr; Wyndaele, Jean‐Jacques

doi:10.1016/j.eururo.2009.04.028

Cited by 479 publications

(449 citation statements)

References 49 publications

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“…4 The European Association of Urology guidelines for neurogenic bladder dysfunction recommend video-UDS investigation every 2 years for patients with normal bladder compliance and without detrusor overactivity and annually for patients with detrusor overactivity and/or low bladder compliance. 17 However, there is little data relating to the value of sequential urodynamic testing, thus there is currently a wide variability in the management strategies amongst specialists. 10,11 Nosseir and colleagues retrospectively investigated the long-term results of 80 SCI patients managed at their institution with a strictly urodynamic-based treatment regime and determined that physiologic changes in bladder function can occur in the absence of changes in overall symptoms, thus they recommended annual urodynamic testing in patients with detrusor overactivity.…”

Section: Discussionmentioning

confidence: 99%

Renal Tract Ultrasonography for Routine Surveillance in Spinal Cord Injury Patients

Edokpolo

Foster

2013

Topics in Spinal Cord Injury Rehabilitation

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Objectives:To report the efficacy of a urinary tract surveillance regime based on annual renal tract ultrasound without routine use of urodynamic testing (UDS) in our population of spinal cord injury (SCI) patients managed with clean intermittent catheterization (CIC). Methods: Data was gathered retrospectively from the records of 48 SCI patients (40 males and 8 females). After establishing a safe system with initial urodynamics, renal ultrasonography was done annually for surveillance. UDS was repeated only when patients presented with new symptoms. The primary endpoint was the report of ultrasound findings at last follow-up. Findings of dilatation, calculi, scarring, and reflux were noted. Results: Mean follow-up was 6.8 years. By final follow-up, pelvicaliectasis was present in 4 (8%) subjects. Mild-moderate hydronephrosis was present in 3 (6%) subjects: 1 stable and 2 (4%) new compared to initial assessment. No severe cases of hydronephrosis were noted. Six (13%) subjects had renal/ureteral calculi. No new cases of renal cortical scarring or thinning were noted. One (2%) subject had high-grade reflux on UDS secondary to a double J stent. Conclusions: Data relating to the efficacy of sequential surveillance studies in SCI patients are scarce, thus there is great variability in urologic surveillance methods worldwide. Upper tract abnormalities detected in our patients were early consequences of acute obstruction rather than late manifestations of detrusor changes and could not have been prevented with more regular urodyamic testing. These results suggest that annual ultrasound monitoring without routine urodynamic testing is an effective surveillance strategy in SCI patients managed with CIC.

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Section: Discussionmentioning

confidence: 99%

Renal Tract Ultrasonography for Routine Surveillance in Spinal Cord Injury Patients

Edokpolo

Foster

2013

Topics in Spinal Cord Injury Rehabilitation

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“…Restoration and maintenance of the patient's QoL should remain among the main targets of the treatment. 3 The present study aimed to investigate the effects of different bladder management methods on the QoL in patients with SCI.…”

Section: Introductionmentioning

confidence: 99%

Effects of different bladder management methods on the quality of life in patients with traumatic spinal cord injury

et al. 2012

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Study design: Multi-center, cross-sectional study. Objectives: To investigate the effects of different bladder management methods on the quality of life (QoL) in patients with spinal cord injury (SCI). Setting: Turkey. Methods: Consecutive SCI patients (n ¼ 195, 74.4% males), for whom at least 6 months had elapsed since the injury, were included and evaluated in five groups: normal spontaneous micturition (NSM), micturition with assisted maneuvers (MAM), aseptic intermittent catheterization by patient (IC-P), aseptic IC by an attendant/caregiver (IC-A) and indwelling catheterization. The King's Health Questionnaire was used to evaluate the patients' QoL. Results: The bladder management groups were similar regarding age, time elapsed since injury, education level, marital and occupational status. There was no difference among the groups in general health perception, personal relationships and sleep/energy domain scores. While the NSM group had generally the lowest scores, that is, better QoL, the IC-A group had the highest scores, that is, poorer QoL, in most of the domains. When the patients were grouped according to the frequency of urinary incontinence or American Spinal Injury Association Impairment Scale grades, no difference was found in the domain scores of the groups except the symptom severity domain scores. No significant difference was found between paraplegic and tetraplegic patients in the King's Health Questionnaire domains. Conclusion: The QoL was notably affected in SCI patients in IC-A group and negative effects on emotional status, physical and social activity limitations were observed, as well.

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“…It is regarded as the last option before urinary diversion. 3 To our knowledge, the use of this procedure not as an elective surgical intervention but as a salvage procedure in an emergency situation has not been reported earlier. In our case, lower urinary tract dysfunction caused severe complications several years earlier, and now resulted in lifethreatening complications that could not be prevented by conservative means.…”

Section: Discussionmentioning

confidence: 92%

Sacral rhizotomy: a salvage procedure in a patient with autonomic dysreflexia

2009

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Study design: Case report. Objectives: To show the feasibility of sacral deafferentation as a salvage procedure to resolve lifethreatening autonomic dysreflexia. Setting: Paraplegic center in Switzerland. Method and results: In a patient presenting with acute autonomic dysreflexia leading to cardiac arrest, sacral deafferentation could prevent further episodes of autonomic dysreflexia. Conclusion: In patients with spinal cord injury, autonomic dysreflexia can be triggered by the bladder even without detrusor overactivity. In these cases, sacral deafferentation may be the only salvage procedure to prevent further serious health problems. Thus, this procedure augments the armamentarium of urologists dealing with patients suffering from spinal cord lesions.

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EAU Guidelines on Neurogenic Lower Urinary Tract Dysfunction

Cited by 479 publications

References 49 publications

Renal Tract Ultrasonography for Routine Surveillance in Spinal Cord Injury Patients

Renal Tract Ultrasonography for Routine Surveillance in Spinal Cord Injury Patients

Effects of different bladder management methods on the quality of life in patients with traumatic spinal cord injury

Sacral rhizotomy: a salvage procedure in a patient with autonomic dysreflexia

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