Investigation and management of neurogenic bladder dysfunction

Fowler, Clare J.; O’Malley, Kiaran

doi:10.1136/jnnp.74.suppl_4.iv27

Cited by 33 publications

(47 citation statements)

References 2 publications

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“…3,4 Unexpected symptoms were seen in 28% of patients and concomitant urological conditions such as prostate enlargement, calculi or infection, or medication, were responsible in nearly half of these patients. The presence of a neurological condition may lead to ''diagnostic shadowing'' whereby all symptoms of LUTD are assumed to be due to the known disease.…”

Section: Discussionmentioning

confidence: 99%

“…6 Such an approach can provide the basic information required for diagnosing and managing neurogenic LUTD. 4 This is relevant in the framework of a neurourological service in regions where resources may be limited and urodynamics not easily available, a situation often encountered in rehabilitation centers in developing countries. However a limitation to this is that the risk for upper renal tract damage may not be assessed initially and this is of importance particularly in patients with higher risk for damage.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5] Accordingly, patients can be categorized into three groups: suprapontine, if the lesion is localized above the level of pons, infrapontine/suprasacral, if the lesion is below the pons and above the sacral cord, or infrasacral, if the lesion is localized to the conus medullaris, cauda equina, or peripheral nerves. 3 Patients with suprapontine lesions would be expected to have storage dysfunction and present with urgency, frequency and urgency incontinence.…”

Section: Introductionmentioning

confidence: 99%

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Lower urinary tract symptoms following neurological illness may be influenced by multiple factors: Observations from a neurorehabilitation service in a developing country

Panicker

Menon

Anandkumar

et al. 2009

Neurourology and Urodynamics

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Lower urinary tract symptoms following neurological illness may be influenced by multiple factors: Observations from a neurorehabilitation service in a developing country

Panicker

Menon

Anandkumar

et al. 2009

Neurourology and Urodynamics

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“…Die Anwendung von Dauerableitungen in der Langzeittherapie bei Patienten mit einer neurogenen Harnblasenfunktionsstörung aufgrund von Schädigungen des Rückenmarks ist aller Regel nach kontraindiziert und bedarf wegen der nekrotischen Druckschäden an der Harnröhre, den unvermeidbaren katheterassoziierten HWI mit besonderen Erregern und besonderen Resistenzen [37] und wegen der erhöhten Tumorrate [38] der Rechtfertigung. Dies gilt insbesondere für die Anwendung von Harnröhrendauerkathe-tern.…”

Section: Dauerkatheterbehandlungunclassified

Moderne neurourologische Therapiestrategien bei Patienten mit Rückenmarksschädigung

Domurath

Kutzenberger

2012

Urologe

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Modern treatment methods for neurogenic bladder dysfunction take into consideration the primacy of obtaining good bladder storage capacity by merely lowering the leak point pressure. The medical benefit for the patient is seen in the stability of renal function and the social advantage in achieving continence. The development of modern findings on the management of neuro-urological disorders in spinal cord injury as well as the underlying principles, indications, and benefits of the most frequently applied treatment approaches are described.

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“…Les vessies neurogènes à basse pression sont rarement accompagnées de dommages structurels ou fonctionnels du haut appareil urinaire [2]. Ces patients peuvent donc être suivis de manière relativement espacée (tous les 24 mois dans notre pratique).…”

Section: Introductionunclassified

Surveillance des vessies neurogènes de l’enfant

Campeau

Corcos

2007

Pelv Perineol

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Les vessies neurogènes chez l'enfant varient dans leur progression vers la détérioration rénale (définissant le pronostic vital) et l'incontinence urinaire (définissant le pronostic fonctionnel). La surveillance visera donc à minimiser ces complications, améliorant ainsi le pronostic et la qualité de vie de ces patients le plus souvent déjà handicapés. Cette surveillance va reposer sur dix éléments essentiels. Une histoire clinique détaillée établit un état de base auquel, par la suite, pourront être comparés les symptômes urinaires, les troubles d'élimination fécale et les infections urinaires de l'enfant. L'impact négatif de la condition mictionnelle et fécale sur la qualité de vie de l'enfant sera évalué par des questions simples et bien ciblées. L'examen physique abdominal et génital externe et l'observation de l'enfant lors de la miction peuvent apporter beaucoup d'informations. Les tests sanguins permettent d'estimer la fonction rénale en suivant le taux de créatinine ; l'analyse et la culture d'urine évaluent la présence d'infections urinaires et le sédiment urinaire. La mesure du volume résiduel postmictionnel identifie la capacité de vidange complète ou partielle de l'enfant. Le bilan urodynamique viendra compléter l'évaluation du pronostic fonctionnel. L'échographie rénale évalue de manière non invasive la taille et la croissance des reins, ainsi que la présence d'hydronéphrose et de lithiases rénales et toute autre anomalie morphologique rénale. La cystographie rétro-grade radiologique ou nucléaire est l'élément qui permet de démontrer et de quantifier un reflux vésico-urétéral. Finalement, la scintigraphie rénale évalue la fonction rénale différentielle, la filtration glomérulaire et le degré éventuel d'obstruction. En conclusion, la surveillance diligente des patients pédiatriques atteints de vessie neurogène anticipe et prévient la détérioration de la fonction vésicale et rénale. Elle permet aussi d'évaluer l'impact et les résultats des traitements pharmacologiques et chirurgicaux.Abstract: Neurogenic bladder in children varies widely in its progression toward renal dysfunction (which could be life threatening) and urinary incontinence (which defines functional prognosis). The goal of monitoring is to minimise these complications, thereby improving the prognosis and quality of life of these often-handicapped patients. Monitoring is based on nine essential elements. Taking a detailed clinical history establishes a baseline for comparing future urinary symptoms, fecal elimination problems and urinary infections. The negative impact of urinary and fecal dysfunction on a child's quality of life can be assessed by simple and directed questions. The abdominal and external genital exam, along with the observation of voiding, can provide valuable information. Determination of serum creatinine levels makes it possible to evaluate renal function, and urine culture and urinalysis tests for the presence of infection. The post-void residual urine volume establishes the voiding ability of the child. Urodynamic st...

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Investigation and management of neurogenic bladder dysfunction

Cited by 33 publications

References 2 publications

Lower urinary tract symptoms following neurological illness may be influenced by multiple factors: Observations from a neurorehabilitation service in a developing country

Lower urinary tract symptoms following neurological illness may be influenced by multiple factors: Observations from a neurorehabilitation service in a developing country

Moderne neurourologische Therapiestrategien bei Patienten mit Rückenmarksschädigung

Surveillance des vessies neurogènes de l’enfant

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