Neurogenic bladder

A United States-based patient-reported adult polyglucosan body disease registry: initial results.

Adult Polyglucosan Body Disease (APBD) is an ultra-rare, genetic neurodegenerative disorder caused by autosomal recessive mutations in the glycogen branching enzyme gene. Knowledge of the demographic and clinical characteristics of APBD patients and the natural history of the disease is lacking.

Post-stroke urinary incontinence is associated with behavior control deficits and overactive bladder.

Although urinary incontinence in stroke survivors can substantially impact the patient's quality of life, the underlying neuropsychological mechanisms and its neural basis have not been adequately investigated.

Consensus update on the therapeutic approach to patients with neurogenic detrusor overactivity

Introduction and objectives: A Consensus document on the management of patients with neurogenic detrusor overactivity (NDO) was published in 2018. The present document aims to update its recommendations regarding treatment considering the new evidence available, and to contribute to the standardization of the management of this disorder.

Methods: The methodology used was based on a systematic review and the Nominal Group Technique. The clinical coordinator (CC) and the Consensus update group (CUG) defined the questions to be updated and carried out a systematic review to identify the new available evidence. After being evaluated by the expert panel, the relevant recommendations were updated and agreed in a consensus meeting.

Results: A total of 3210 publications were identified and 26 publications that met the inclusion criteria were included. The CUG updated 18 recommendations on the therapeutic approach to NDO. Unanimous consensus was reached on all of them.

Conclusions: Previous recommendations need to be revised due to the availability of new drugs, the increasing evidence on the use of botulinum toxin or neuromodulation procedures, and new surgical options.

A Borau,1 J Salinas,2 M Allué,3 D Castro-Diaz,4 M Esteban,5 S Arlandis,6 M Virseda,7 J M Adot8

  1. Insituto Guttmann, Barcelona, Spain. Electronic address: .
  2. Hospital Clínico San Carlos, Madrid, Spain.
  3. Hospital Universitario Vall d´Hebron, Barcelona, Spain.
  4. Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain.
  5. Hospital Nacional de Parapléjicos, Toledo, Spain.
  6. Hospital Universitario y Politécnico La Fe, Valencia, Spain.
  7. Hospital Clinico San Carlos, Madrid, Spain.
  8. Hospital General Universitario, Burgos, Spain.

Source: A Borau, J Salinas, M Allué et al. Consensus update on the therapeutic approach to patients with neurogenic detrusor overactivity. Actas Urol Esp (Engl Ed). 2024 May 14:S2173-5786(24)00073-8. doi: 10.1016/j.acuroe.2024.05.013.

Effectiveness and patient perspective on the use of intravesical gentamicin instillations to treat recurrent urinary tract infections in neurogenic lower urinary tract dysfunction.

Patients with neurogenic lower urinary tract dysfunction (NGLUTD) who require catheterization either with clean intermittent catheters (CIC) or indwelling catheters suffer with frequent urinary tract infections (UTIs).

Hydrophilic catheters for intermittent catheterization and occurrence of urinary tract infections. A retrospective comparative study in patients with spinal cord Injury.

Neurogenic bladder dysfunction is a major problem for spinal cord injury (SCI) patients not only due to the risk of serious complications but also because of the impact on quality of life. The main aim of this study is to compare the rate of urinary tract infection (UTI) associated with hydrophilic-coated catheters versus uncoated polyvinyl chloride (PVC) catheters among SCI patients presenting with functional neurogenic bladder sphincter disorders.

Risk factors of video urodynamics and bladder management for long-term complications in patients with chronic spinal cord injury.

This study explores 15-year urological complications in chronic spinal cord injury (SCI) patients and investigates the predictive factors from video-urodynamic study (VUDS) and bladder management. Analyzing 864 SCI patients with a mean 15.

Adherence of spinal cord injury patients in the community to self-clean intermittent catheterization (CIC) within 12 months of discharge following rehabilitation: A telephone survey.

Spinal cord injury often results in neurogenic bladder affecting storage or emptying functions of the bladder. Clean intermittent catheterization (CIC) is considered the gold standard for patients with neurogenic bladder dysfunction.

Intravesical oxybutynin treatment for neurogenic detrusor overactivity : Efficacy and safety data from clinical practice with the first intravesical oxybutynin treatment authorized in Germany.

Existing therapies for neurogenic detrusor overactivity (NDO), i.e. oral anticholinergics and botulinum toxin injections, can be associated with serious adverse effects or are not always sufficiently effective.

Stem Cell and Neural Progenitor Cell Therapy for Neurogenic Bladder – Where Are We in 2023? - Beyond the Abstract

Neurogenic bladder is a complex condition that can develop as a result of damage to the nervous system (Figure 1).1 Significant advancements have been made in treating neurogenic bladder utilizing regenerative medicine approaches. Therefore, our study titled “Stem Cell and Neural Progenitor Cell Therapy for Neurogenic Bladder – Where Are We in 2023?,” published in Current Bladder Dysfunction Reports, aimed to summarize recent literature on this crucial topic.2

Stem Cell and Neural Progenitor Cell Therapy for Neurogenic Bladder—Where Are We in 2023?

Purpose of Review: This review aims to consolidate the currently available literature regarding the treatment of neurogenic bladder (NGB) with stem cells or neural progenitor cells (NPCs).

Recent Findings: Several promising studies published in the past 5 years suggest therapeutic potential of stem cells in treating NGB. In vitro models of NGB have demonstrated the efficacy of stem cells from varying sources to induce nerve regeneration while simultaneously improving bladder function parameters. Additionally, mesenchymal stem cells (MSCs) were found to inhibit fibrosis through the TGF-β1 signaling pathway while their effects were potentiated by elevated levels of BDNF or SDF-1. Among induced pluripotent stem cells (iPSCs), it was noted that autophagy inducers improved regenerative effects. NPCs, in a recent clinical trial, also underscored the potential for translating stem cell therapies into practice.

Summary: Stem cells offer a potentially revolutionary regenerative medicine strategy for treatment of NGB. Many in vivo trials are promising, but there is a distinct shortage of clinical trials attempting to translate this success into human subjects. In the future, research should be directed towards understanding the complex mechanisms of stem cell-based therapy while moving towards the clinical applications of the technology.

Ilaha Isali, Thomas R. Wong & Adonis Hijaz

Department of Urology, University Hospitals Cleveland Medical Center, Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH

Source: Ilaha Isali, Thomas R. Wong & Adonis Hijaz. Stem Cell and Neural Progenitor Cell Therapy for Neurogenic Bladder—Where Are We in 2023? Curr Bladder Dysfunct Rep (2024). https://doi.org/10.1007/s11884-024-00742-w. 

Go Beyond the Abstract and Read a Commentary by the Authors

Lower Urinary Tract Dysfunction in Pediatric Patients with Multiple Sclerosis: Diagnostic and Management Concerns.

Multiple sclerosis (MS) is increasing in the pediatric population and, as in adults, symptoms vary among patients. In children the first manifestations can sometimes overlap with acute neurological symptoms.

Invasive neurostimulation in neuro-urology: state of the art.

Modulation or stimulation of the nerves supplying the lower urinary tract is a possible treatment option for dysfunction of the lower urinary tract, pelvic floor and rectum if conservative or minimally invasive treatment approaches fail.

Outcomes of detrusorectomy in neurogenic bladders: A systematic review and meta-analysis.

This systematic review and meta-analysis aims to assess the outcomes of detrusorectomy in children with neurogenic bladder (NB).

A search was performed in PUBMED, EMBASE and the Cochrane Library database in August 2023.

The impact of anticholinergics on cognitive function in patients with neurogenic lower urinary tract dysfunction: A narrative review.

This narrative review discusses the relationship between anticholinergic medications and cognitive change specifically in patients with neurogenic lower urinary tract dysfunction (NLUTD). NLUTD is prevalent in various conditions, including spinal cord injury (SCI), spina bifida (SB), multiple sclerosis (MS), Parkinson's, stroke, and dementia and often requires anticholinergic overactive bladder (OAB) medications.

Effect of Bladder Volume and Compliance on Ultrasonographic Measurement of Bladder Wall Thickness in Children with Neurogenic Bladder Dysfunction - Beyond the Abstract

Neurogenic bladder dysfunction, frequently seen in children with spina bifida, challenges traditional diagnostic approaches like urodynamics due to its invasive nature. The non-invasive measurement of bladder wall thickness (BWT) via ultrasonography offers a potential complementary diagnostic tool, yet its efficacy relative to bladder volume and compliance remains underexplored.

Comparison of the efficiency of transcutaneous electrical nerve stimulation and manual therapy in children with cerebral palsy with lower urinary system dysfunction- a randomized prospective trial.

Neurological defects in children with cerebral palsy (CP) not only affect their motor skills but also lead to bladder and bowel problems. Although most children with CP have achieved urinary control, more than 50% of cases experience lower urinary tract symptoms (LUTS).

Safety and efficacy of beta-3 adrenergic agonists in treating neurogenic lower urinary tract dysfunction: A systematic review and meta-analysis.

To evaluate efficacy and safety of beta-3 adrenergic agonists in adults with neurogenic lower urinary tract dysfunction.

According to a protocol (CRD42022350079), we searched multiple data sources for published and unpublished randomized controlled trials (RCTs) up to 2nd August 2022.

Isolated continent cystostomy on neurologic native bladder: Functional results.

Continent cutaneous urinary diversion (CCUD) is proposed to patients suffering from chronic neurologic retention and undergoing intermittent self-catheterization (ISC). In case of neurogenic detrusor overactivity (NDO), augmentation enterocystoplasty is often required.

The impact of bladder problems on well-being in multiple sclerosis - A cross-sectional study.

Persons with multiple sclerosis (pwMS) frequently suffer from bladder problems that are not identified and managed optimally, reducing quality of life and increasing risk of health consequences.

This study aimed to investigate associations between bladder problems and well-being of pwMS.

Quality of Life and Bladder Symptoms in Adolescents and Young Adults With Spina Bifida Who Catheterize via Urethra Versus Catheterizable Channel.

To assess associations between health-related quality of life (HRQOL), bladder-related QOL, bladder symptoms, and bladder catheterization route among adolescents and young adults (AYA) with spina bifida (SB).