title: Neurogenic lower urinary tract dysfunction: Clinical management recommendations of the Neurologic Incontinence committee of the fifth International Consultation on Incontinence 2013.
abstract: 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.
  
  
  
  To update clinical management of neurogenic bladder dysfunction from the recommendations of the fourth ICI, 2009.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: School of Surgical Sciences, University of Bristol, United Kingdom.
authors.forename: Marcus John
authors.initials: MJ
authors.lastname: Drake
authors.affiliation: Aristotle University, Thessaloniki, Greece.
authors.forename: Apostolos
authors.initials: A
authors.lastname: Apostolidis
authors.affiliation: University of Florence, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Cocci
authors.affiliation: University College London, United Kingdom.
authors.forename: Anton
authors.initials: A
authors.lastname: Emmanuel
authors.affiliation: Dalhousie University, Halifax, Canada.
authors.forename: Jerzy B
authors.initials: JB
authors.lastname: Gajewski
authors.affiliation: Pinderfields Hospital, Wakefield, United Kingdom.
authors.forename: Simon C W
authors.initials: SC
authors.lastname: Harrison
authors.affiliation: Radboud University, Nijmegen, The Netherlands.
authors.forename: John P F A
authors.initials: JP
authors.lastname: Heesakkers
authors.affiliation: UT Southwestern Medical Center, Dallas, Texas.
authors.forename: Gary E
authors.initials: GE
authors.lastname: Lemack
authors.affiliation: Innsbruck University Hospital, Austria.
authors.forename: Helmut
authors.initials: H
authors.lastname: Madersbacher
authors.affiliation: University College London, United Kingdom.
authors.forename: Jalesh N
authors.initials: JN
authors.lastname: Panicker
authors.affiliation: Department of Urology, Medical University of Warsaw, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Radziszewski
authors.affiliation: Toho University, Tokyo, Japan.
authors.forename: Ryuji
authors.initials: R
authors.lastname: Sakakibara
authors.affiliation: University of Antwerp, Belgium.
authors.forename: Jean Jacques
authors.initials: JJ
authors.lastname: Wyndaele
mesh_terms: D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000503:physiopathology / Q000628:therapy*; D011788:Quality of Life; D001743:Urinary Bladder / Q000503:physiopathology*; D001750:Urinary Bladder, Neurogenic / Q000503:physiopathology / Q000628:therapy*; D014549:Urinary Incontinence / Q000503:physiopathology / Q000628:therapy*
keywords: neurogenic; overactive bladder; urinary incontinence