Premium
Neurogenic lower urinary tract dysfunction: Clinical management recommendations of the Neurologic Incontinence committee of the fifth International Consultation on Incontinence 2013
Author(s) -
Drake Marcus John,
Apostolidis Apostolos,
Cocci Andrea,
Emmanuel Anton,
Gajewski Jerzy B.,
Harrison Simon C.W.,
Heesakkers John P.F.A.,
Lemack Gary E.,
Madersbacher Helmut,
Panicker Jalesh N.,
Radziszewski Piotr,
Sakakibara Ryuji,
Wyndaele Jean Jacques
Publication year - 2016
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.23027
Subject(s) - medicine , urinary incontinence , context (archaeology) , urodynamic testing , urinary system , quality of life (healthcare) , intensive care medicine , disease , lower urinary tract symptoms , overactive bladder , multidisciplinary approach , urology , alternative medicine , nursing , pathology , prostate , paleontology , social science , cancer , sociology , biology
Background 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. Aims To update clinical management of neurogenic bladder dysfunction from the recommendations of the fourth ICI, 2009. Materials and methods 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. Results 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. Discussion The review offers a pragmatic review of management in the context of complex pathophysiology and varied evidence base. Neurourol. Urodynam. 35:657–665, 2016 . © 2016 Wiley Periodicals, Inc.