[Highlighting differences in the management of neurogenic bladder existing between urologists and physiatrists: A survey conducted among 383 specialists].
OBJECTIVE
To investigate and evaluate the quality of care and follow-up provided to neurogenic patients by urologists and physiatrists in France.


METHODS
A survey was conducted by the French-speaking group of neuro-urology (GENULF) among French urologists and physiatrists in 2009. Three thousand one hundred and eighty questionnaires were sent to the members of four scientific societies. Questions focused on aetiology, consultation, clinical follow-up and symptom management.


RESULTS
Two hundred and seventy-four urologists and 109 physiatrists completed the questionnaire, 76% and 84% respectively had experience in neuro-urology. Only a few specialists performed multidisciplinary consultations. Systematic follow-up frequency varied between 6 to 12 months. Eighty-three percent of physiatrists and 56% of urologists performed a urodynamic follow-up, mostly yearly. Physiatrists used invasive imaging techniques more often than urologists. They also treated asymptomatic bacteriuria in catheterised patients more often than urologists. Self-catheterisation was a standard treatment to address urinary retention. Both specialists prescribed botulinum toxin type A injections.


CONCLUSIONS
National and international guidelines related to follow-up and treatments were followed by both specialists. Urologists and physiatrists treated asymptomatic bacteriuria more often than necessary. Urodynamics testing was not carried out as often as recommended by guidelines. Urologists offered a more frequent follow-up than physiatrists. Physiatrists performed more often and better urodynamic follow-up compared to urologists.


CONCLUSIONS
Our survey revealed a good observance of national and international guidelines by French specialists for the management of neurogenic bladder patients. Nevertheless, the management of these patients could be harmonised and possibly improved by putting an accent on specialists' education, by using assessment forms regarding their practices and by increasing the amount of multidisciplinary consultations.
AP-HP, groupe hospitalier Raymond-Poincaré, service de médecine physique et de réadaptation, 92380 Garches, France. pierre.denys@rpc.aphp.fr
Pierre
P
Denys
Jean-Marc
JM
Soler
Brigitte
B
Fatton
Pascal
P
Rischmann
Alain
A
Yelnik
Philippe
P
Aegerter
Nabila-Yasmine
NY
Saidji-Domingo
Emmanuel
E
Chartier-Kastler
D005260:Female; D005602:France; D006306:Health Surveys; D006801:Humans; D008297:Male; D010820:Physicians; D010818:Practice Patterns, Physicians'; D011570:Psychiatry; D011787:Quality of Health Care; D013038:Specialization; D011795:Surveys and Questionnaires; D001750:Urinary Bladder, Neurogenic / Q000175:diagnosis / Q000628:therapy*; D014572:Urology; D000078329:Workforce