Management of the neuropathic bladder

2020 ◽  
pp. 651-708
Author(s):  
Suzanne Biers ◽  
Noel Armenakas ◽  
Alastair Lamb ◽  
Stephen Mark ◽  
John Reynard ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Urinary Tract ◽  
Lower Urinary Tract ◽  
Sphincter Function ◽  
Cord Injury ◽  
Bladder Management ◽  
Clinical Consequences ◽  
Management Techniques ◽  
Neurological Conditions ◽  
Tract Infections

A variety of neurological conditions are associated with abnormal bladder and sphincter function, e.g. spinal cord injury (SCI), spina bifida (myelomeningocele), and multiple sclerosis (MS). The bladder and sphincters of such patients are described as ‘neuropathic’. This chapter describes the clinical consequences with the neuropathic lower urinary tract, bladder management techniques, and cystoplasty. It also provides management of incontinence, recurrent urinary tract infections, and hydronephrosis. Finally, it also covers catheters and condoms and artificial urinary sphincters.

Neuropathic bladder

2013 ◽  
pp. 603-638
Author(s):  
John Reynard ◽  
Simon Brewster ◽  
Suzanne Biers
Keyword(s):  
Urinary Tract ◽  
Neurological Disease ◽  
Lower Urinary Tract ◽  
Neuropathic Bladder ◽  
Bladder Management ◽  
Clinical Consequences ◽  
Urine Storage ◽  
Management Techniques ◽  
Lower Urinary

Innervation of the lower urinary tract (LUT) 604 The physiology of urine storage and micturition 608 Bladder and sphincter behaviour in the patient with neurological disease 610 The neuropathic lower urinary tract: clinical consequences of storage and emptying problems 612 Bladder management techniques for the neuropathic patient ...

scholarly journals Adult Neurogenic Lower Urinary Tract Dysfunction and Intermittent Catheterisation in a Community Setting: Risk Factors Model for Urinary Tract Infections

2019 ◽  
Vol 2019 ◽  
pp. 1-13 ◽  
Author(s):  
Michael Kennelly ◽  
Nikesh Thiruchelvam ◽  
Márcio Augusto Averbeck ◽  
Charalampos Konstatinidis ◽  
Emmanuel Chartier-Kastler ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Lower Urinary Tract ◽  
Cauda Equina ◽  
Lower Urinary Tract Dysfunction ◽  
Intermittent Catheterisation ◽  
Cord Injury ◽  
Tract Infections ◽  
Lower Urinary

A risk factor model for urinary tract infections in patients with adult neurogenic lower urinary tract dysfunction performing clean intermittent catheterisation was developed; it consists of four domains, namely, (1) general (systemic) conditions in the patient, (2) individual urinary tract conditions in the patient, (3) routine aspects related to the patient, and (4) factors related to intermittent catheters per se. The conceptual model primarily concerns patients with spinal cord injury, spina bifida, multiple sclerosis, or cauda equina where intermittent catheterisation is a normal part of the bladder management. On basis of several literature searches and author consensus in case of lacking evidence, the model intends to provide an overview of the risk factors involved in urinary tract infections, with specific emphasis to describe those that in daily practice can be handled and modified by the clinician and so come to the benefit of the individual catheter user in terms of fewer urinary tract infections.

scholarly journals Lower urinary tract symptoms associated with neurological conditions: Observations on a clinical sample of outpatients neurorehabilitation service

2015 ◽  
Vol 87 (2) ◽  
pp. 154 ◽  
Author(s):  
Fabrizio Torelli ◽  
Erica Terragni ◽  
Salvatore Blanco ◽  
Natale Di Bella ◽  
Marco Grasso ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Urinary Tract ◽  
Lower Urinary Tract Symptoms ◽  
Urge Incontinence ◽  
Lower Urinary Tract ◽  
Clinical Sample ◽  
Urinary Symptoms ◽  
Urinary Tract Symptoms ◽  
Neurological Conditions ◽  
Lower Urinary

Objectives: The overall aims of this study were to investigate the lower urinary tract symptoms (LUTS) associated with neurological conditions and their prevalence and impact on a clinical sample of outpatients of a neurorehabilitation service. Materials and methods: We reviewed the files of 132 patients treated in our neurorehabilitation service from December 2012 to December 2013. Patients were divided into several subgroups based on the neurological diagnosis: Multiple Sclerosis (MS), other demyelinating diseases, Peripheral Neuropathy, neurovascular disorders (ND), neoplastic disease, traumatic brain injury (TBI), Parkinson and Parkinsonism, spinal cord injuries (SCI). Urinary status was based on medical evaluations of history of LUTS, type, degree, onset and duration of symptoms. We tried to analyze prevalence, kind of disorder, timing of presentation (if before or after the neurological onset) and eventual persistence of urological disorders (in the main group and in all subgroups). Results: At the time of admission to our rehabilitation service, LUTS were observed in 14 out of 132 cases (11%). A high proportion of these outpatients (64.2%) presented bothersome urinary symptoms such as incontinence, frequency and urgency (storage LUTS). The most frequent symptom was urinary urge incontinence (42.8%). This symptom was found to be prevalent in the multiple sclerosis and neurovascular disorders. In 93% the urinary symptoms arose as a result of neurologic conditions and 78.5% did not present a complete recovery of urological symptoms in spite of improved selfreported functional activity limitations. None of these patients performed urological rehabilitation. Conclusions: Neurological disorders are a significant issue in rehabilitation services and it can lead to lower tract dysfunction, which causes LUTS. Storage symptoms are more common, especially urge incontinence. Current literature reports that a further optimization of the rehabilitation potential of neurologically ill patients is possible through an implementation of urological basic measures into the neurological treatment routine.

Neuropathic bladder

2019 ◽  
pp. 621-656
Author(s):  
John Reynard ◽  
Simon F Brewster ◽  
Suzanne Biers ◽  
Naomi Laura Neal
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Urinary Tract ◽  
Spina Bifida ◽  
Urinary Tract Infections ◽  
Neuropathic Bladder ◽  
The Third ◽  
Cord Injury ◽  
Tract Infections

This chapter reviews the management of the various urological problems that individuals with neurological disorders (spinal cord injury, multiple sclerosis, Parkinson’s disease, spina bifida, after stroke) may experience, from incontinence, recurrent urinary tract infections, and hydronephrosis. Management of the neuropathic bladder remains much as it was at the time of the third edition of this handbook.

scholarly journals Post-injury bladder management strategy influences lower urinary tract dysfunction in the mouse model of spinal cord injury

2016 ◽  
Vol 36 (5) ◽  
pp. 1301-1305 ◽  
Author(s):  
Naoki Wada ◽  
Takahiro Shimizu ◽  
Shun Takai ◽  
Nobutaka Shimizu ◽  
Anthony J. Kanai ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Urinary Tract ◽  
Lower Urinary Tract ◽  
Management Strategy ◽  
Lower Urinary Tract Dysfunction ◽  
Post Injury ◽  
Cord Injury ◽  
Bladder Management ◽  
Lower Urinary

Dynamics of symptoms of genitourinary menopausal syndrome and the frequency of recurrence of lower urinary tract infection in women in periand postmenopausal patients with combined therapy with Trioginal®

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (6) ◽  
pp. 67-72
Author(s):  
D Yu Pushkar ◽  
M Yu Gvozdev
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract ◽  
Urine Culture ◽  
Objective Assessment ◽  
Control Group ◽  
Urination Disorders ◽  
Menopausal Syndrome ◽  
Tract Infections ◽  
Two Stages ◽  
Lower Urinary

Material and methods. The study included patients (n=164) in peri- and postmenopause, having a laboratory-confirmed picture of the genitourinary menopausal syndrome - atrophic vulvovaginitis and suffering from recurrent lower urinary tract infections (UTI) - cystitis and urethritis. All patients underwent standard antibacterial therapy (ABT) UTI in accordance with the results of bacteriological urine culture according to Russian clinical guidelines on urology. Against the background of ABT, 164 patients received additional therapy with Trioginal® (the study group - SG) containing estriol, micronized progesterone and Lactobacillus casei rhamnosus Doderleini 35 (LCR 35) lactobacillus strain. Trioginal® was administered intravaginally in two stages: for 20 days, 2 capsules per day, then for 10 days, 1 capsule per day. In the comparison group - CG (n=67) with ABT, Ovipol Klio® (estriol monopreparation) was additionally intravaginally used in two stages: for 14 days, 1 suppository per day, then for 2 weeks, 1 suppository 2 times a week. The control group consisted of 30 patients receiving only standard ABT UTI, local hormone therapy for vulvovaginal atrophy (VVA) was not performed. The observation period was 12 months after the end of the course of therapy. At all stages of treatment, a subjective and objective assessment of the severity of urination disorders and urogenital atrophy (UDI-6 questionnaire), their impact on the quality of life of patients (questionnaire IIQ-7), indicators of bacteriuria, bacterial urine culture and vaginal biocenosis, frequency of undesirable phenomena were carried out. According to the initial characteristics of the group of patients were comparable. Results. At all stages of the study, in the group of patients who received therapy with the use of the Trioginal® drug, there was a significant improvement in the clinical picture of urination disorders compared to the CG and the control (main) group - MG (in SG - 18% at the end of therapy versus 100% before the start of therapy; CG - 26 % versus 100% respectively; Ledger - 58% versus 100% respectively; p

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