Lower urinary tract dysfunction is common in patients with neurological disease. Storage and/or voiding function can be affected, leading to bothersome symptoms. However, preventing upper urinary tract deterioration is a greater clinical priority, requiring identification of patients at risk, early intervention where indicated, and ongoing surveillance.
An initial assessment requires a comprehensive evaluation, including wider issues such as aspirations for independent living, cognitive function, manual dexterity, and mobility. Measures to improve urine storage include antimuscarinic drugs, botulinum injections, or surgical procedures. For voiding dysfunction, intermittent catheterization is by far the most effective and most widely applicable approach, with additional benefits for urinary storage. The assessment of urinary tract function and treatment selection requires a multidisciplinary approach in the context of full rehabilitation or support.
Marcus J Drake, Francisco MJ Cruz
Date Received: April 26, 2011
Accepted on: January 17, 2012
KEYWORDS: Neurourology; Detrusor overactivity; Urodynamics; Antimuscarinics; Botulinum toxin A
CORRESPONDENCE: Marcus J Drake, MA, DM, FRCS (Urology), University of Bristol, Bristol Urological Institute, Southmead Hospital, Bristol, BS10 5NB, United Kingdom ( ).
CITATION: UroToday Int J. 2012 Feb;5(1):art 95.
doi: http://dx.doi.org/10.3834/uij.1944-5784.2012.02.13