[Benign prostatic hyperplasia and neurourology].
Benign prostatic hyperplasia, which is usually treated conservatively (except in the presence of complications) in non-neurological patients, needs to be managed even more cautiously in patients with neurogenic bladder. The treatment decision must include analysis of the previous voiding mode. The development of detrusor-sphincter dyssynergia in an elderly man with a neurological disease must raise the suspicion of prostatic obstruction. The difficulty of establishing a diagnosis of obstruction, that cannot always be confirmed by clinical tools, urodynamic assessment or the search for renal complications, may lead to temporary prostatic stenting as a diagnostic procedure. Certain situations are more specifically encountered in patients with neurogenic bladder: spinal cord injury patients with reflex voiding, patients with stroke and its sequelae, ageing men and diabetic patients.
Chartier-Kastler
E
E
Service d'urologie, GH Pitié Salpétrière, Université Paris VI, France. emmanuel.chartier-kastler@psl.aphp.fr
Mozer
P
P
Ayoub
N
N
Richard
F
F
Ruffion
A
A
D006801:Humans; D007674:Kidney Diseases / Q000209:etiology; D008297:Male; D015917:Penile Prosthesis; D011470:Prostatic Hyperplasia / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D011474:Prosthesis Design; D001750:Urinary Bladder, Neurogenic / Q000209:etiology