title: [Neuro-urology--development of a new focus in rehabilitation of the spinal cord injured patient].
abstract: While preservation of renal function continues to be the primary objective in the urological care of spinal cord injured patients, new treatment principles have resulted in increased attention being given also to restoration of lost urinary continence, a goal shared by the patient as well. The fact that intermittent catheterization has stood the test also for the long-term management of micturition, as well as the development of effective medication for hyperreflective detrusor relaxation have resulted in a treatment concept that enables 70 percent of those treated to achieve dry intervals between catheterizations. Effective electromiction is today enabled by the sacral anterior root stimulator (Brindley), with continence ensured by sacral deafferentation performed at the same time; both measures have proved successful at medium term. Bladder augmentation is another operative measure for controlling detrusor hyperreflexia. Neurogenic urinary stress incontinence can be tackled successfully by implanting an hydraulic sphincter system (Scott). Both the advantages and the possible disadvantages or risks of these new management concepts are set out, dealing also with their indications. Successful treatment of erectile dysfunction is possible today, and inseminable sperma can be obtained in some 40 to 50 percent of the spinal cord injured patients.
authors.affiliation: A. ö. Landeskrankenhaus Universitätskliniken, Innsbruck.
authors.forename: H
authors.initials: H
authors.lastname: Madersbacher
mesh_terms: D003131:Combined Modality Therapy; D007172:Erectile Dysfunction / Q000534:rehabilitation; D006801:Humans; D008297:Male; D009460:Neurologic Examination; D012047:Rehabilitation Centers; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D001750:Urinary Bladder, Neurogenic / Q000534:rehabilitation*; D014549:Urinary Incontinence / Q000534:rehabilitation*
vernacular_title: Neurourologie--Neue Schwerpunktbildung in der Rehabilitation des Querschnittgelähmten.