title: Neurogenic lower urinary tract dysfunction: evaluation and management.
abstract: The lower urinary tract (LUT) in health is regulated by coordinated multi-level neurological inputs which require an intact central and peripheral nervous system. Lower urinary tract dysfunction is, therefore, a common sequelae of neurological disease and the patterns of bladder storage and voiding dysfunction depend upon the level of neurological lesion. Evaluation includes history taking, bladder diary, urological examination when relevant, ultrasonography and urodynamic testing when indicated. Antimuscarinic agents are the first line treatment for patients with storage dysfunction. Alternative treatments include intradetrusor injection of onabotulinumtoxinA, which has been shown to be of benefit in patients with neurogenic detrusor overactivity (NDO), and neuromodulation. Intermittent catheterization remains the option of choice in patients with significant voiding dysfunction resulting in high post-void residual volumes.
authors.affiliation: Department of Neurology, University Hospital Center Zagreb, Kispaticeva 12, Zagreb, 10000, Croatia. tudorkatarinaivana@gmail.com.
authors.forename: Katarina Ivana
authors.initials: KI
authors.lastname: Tudor
authors.affiliation: Neurology Division, Department of Internal Medicine, Sakura Medical Center, Toho University, Sakura, Japan.
authors.forename: Ryuji
authors.initials: R
authors.lastname: Sakakibara
authors.affiliation: Department of Uro-Neurology, The National Hospital for Neurology and Neurosurgery, Institute of Neurology, University College London (UCL), Queen Square, London, UK.
authors.forename: Jalesh N
authors.initials: JN
authors.lastname: Panicker
mesh_terms: D019468:Disease Management; D018450:Disease Progression; D006801:Humans; D009422:Nervous System Diseases / Q000150:complications*; D014570:Urologic Diseases / Q000175:diagnosis / Q000209:etiology / Q000628:therapy
keywords: Antimuscarinics; Fowler’s syndrome; Incontinence; Neurogenic bladder; OAB; Overactive bladder; Tibial nerve stimulation; Urodynamics