Neurogenic Bladder: from Diagnosis to Management

Abstract

Patients with spinal cord injury (SCI) present with a wide range and variety of urologic manifestations, depending upon the level of injury. Historically, patients with spinal cord injury experienced significant mortality related to renal failure. Greater knowledge of the pathophysiology of SCI, however, has contributed to a reduction in mortality. It is essential to perform a thorough initial evaluation and regular follow-up of these patients to achieve the primary goal of preservation of renal function, with the secondary goal of optimizing the patient's quality of life.

Combinational effects of muscarinic receptor inhibition and β3‐adrenoceptor stimulation on neurogenic bladder dysfunction in rats with spinal cord injury

“…Neurogenic bladder dysfunction due to spinal cord injury (SCI) includes detrusor overactivity (DO) and low bladder compliance. In clinical practice, these functional abnormalities can induce bladder deformity, reduction of bladder capacity, hydronephrosis and vesicoureteral reflux (VUR), potentially resulting in renal dysfunction, and a decline in quality of life (QoL) along with the progression of urinary incontinence . Therefore, the major aim of treatment for neurogenic bladder dysfunction is to manage DO and low bladder compliance properly, thereby keeping the normal renal function and improving the QoL.…”

Urinary tract infections, urologic surgery, and renal dysfunction in a contemporary cohort of traumatic spinal cord injured patients

“…To our knowledge, little has been published on the rate of urologic reconstruction/urinary diversion among SCI patients; most of the literature consists of mixed case series from expert centers. 9,22 In general, urinary incontinence is common among SCI patients 23 ; however, we found that the utilization of urologic reconstruction/urinary diversion surgeries (including stress incontinence procedures) is low. With further follow-up, progressive neurogenic bladder dysfunction, and failure of more conservative treatment options, the use of these procedures may increase.…”

A historical perspective and evolution of the treatment of male urinary incontinence

“…34 Neurogenic bladder dysfunction with varying degrees of detrusor hypo/hyper or areflexia and sphincter tone deficiencies causing incontinence can be treated with clean intermittent catheterization (CIC), indwelling catheter (urethral or suprapubic) placement and onabotulinumtoxinA injections. 35 Similarly, bladder outlet obstruction (BOO) typically leads to urinary retention but can present as overflow incontinence in males and is primarily managed with an indwelling catheter and/or prostate reduction surgeries. 36 While transurethral bulking agents have been described as a viable option for urinary incontinence, results are mixed and short-lived, if any.…”