Evidence-based guidelines for the management of neurological disease and lower urinary tract dysfunction have been produced by the International Consultations on Incontinence (ICI). These are comprehensive guidelines, and were developed to have world-wide relevance.
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To update clinical management of neurogenic bladder dysfunction from the recommendations of the fourth ICI, 2009.
A series of evidence reviews and updates were performed by members of the working group. The resulting guidelines were presented at the 2012 meeting of the European Association of Urology for consultation, and consequently amended to deliver evidence-based conclusions and recommendations in 2013.
The current review is a synthesis of the conclusions and recommendations, including the algorithms for initial and specialized management of neurogenic lower urinary tract dysfunction. The pathophysiology is categorized according to the nature of onset of neurological disease and the part(s) of the nervous system affected. Assessment requires clinical evaluation, general investigations, and specialized testing. Treatment primarily focuses on ensuring safety of the patient and optimizing quality of life. Symptom management covers conservative and interventional measures to aid urine storage and bladder emptying, along with containment of incontinence. A multidisciplinary approach to management is essential.
The review offers a pragmatic review of management in the context of complex pathophysiology and varied evidence base. Neurourol. Urodynam. © 2016 Wiley Periodicals, Inc.
Neurourology and urodynamics. 2016 May 13 [Epub ahead of print]
Marcus John Drake, Apostolos Apostolidis, Andrea Cocci, Anton Emmanuel, Jerzy B Gajewski, Simon C W Harrison, John P F A Heesakkers, Gary E Lemack, Helmut Madersbacher, Jalesh N Panicker, Piotr Radziszewski, Ryuji Sakakibara, Jean Jacques Wyndaele
School of Surgical Sciences, University of Bristol, United Kingdom., Aristotle University, Thessaloniki, Greece., University of Florence, Italy., University College London, United Kingdom., Dalhousie University, Halifax, Canada., Pinderfields Hospital, Wakefield, United Kingdom., Radboud University, Nijmegen, The Netherlands., UT Southwestern Medical Center, Dallas, Texas., Innsbruck University Hospital, Austria., University College London, United Kingdom., Department of Urology, Medical University of Warsaw, Poland., Toho University, Tokyo, Japan., University of Antwerp, Belgium.