2. UroToday Home
  3. Urinary Catheters
  4. Indwelling Catheters
  5. Complications
  6. UroToday

Neurogenic bladder

Neurogenic bladder

Is It Possible to Regenerate the Underactive Detrusor? Part 1 Molecular and Stem Cell Therapies Targeting the Urinary Bladder and Neural Axis ICI-RS 2024.

Detrusor muscle weakness is commonly noted on urodynamics in patients with refractory voiding difficulty. No approved therapies have been proven to augment the strength of a detrusor voiding contraction.

Deterioration of cystometric parameters following the artificial urinary sphincter procedure in patients with spinal cord lesion: a retrospective analysis.

The artificial urinary sphincter (AUS) remains the gold standard to treat stress urinary incontinence related to sphincter insufficiency in patients with neurogenic lower urinary tract dysfunction (NLUTD).

Urodynamic and Frequency-Volume Chart Parameters Influencing Anticholinergic Resistance in Patients With Neurogenic Detrusor Overactivity.

Neurogenic detrusor overactivity (NDOA) is characterized by involuntary detrusor muscle contractions during bladder filling in patients with neurological disorders. Anticholinergic therapy is the primary treatment; however, the reasons for treatment resistance in NDOA are not well understood.

Role of detrusor overactivity and interval between bladder sensations on the severity of overactive bladder symptoms in patients with multiple sclerosis.

This study aimed to assess the relationship between kinetics of bladder sensations perception, detrusor overactivity (DO), and severity of overactive bladder (OAB) symptoms in patients with multiple sclerosis (PwMS).

Acceptance and the influencing factors towards intermittent self-catheterisation among patients with neurogenic lower urinary tract dysfunction in China: a multicentre cross-sectional study.

The psychological acceptance of intermittent self-catheterisation (ISC) significantly impacts its initial adoption and long-term compliance among patients. However, our understanding of this acceptance remains limited.

Expression of Wnt signaling proteins in rare congenital bladder disorders.

Congenital bladder anomalies are rare and are a leading cause of end stage renal failure in children. The Wnt signaling pathway, important during embryonic development, has been implicated in the pathogenesis of these conditions through regulation of gene expression, including essential transcription factors.

A Meta-Analysis on the Efficacy and Safety of Sacral Neuromodulation for Neurogenic Bladder or Bowel Dysfunction.

The aim of this work was to evaluate the efficacy and safety of sacral neuromodulation (SNM) in the treatment of neurogenic bladder (NB) and neurogenic bowel dysfunction (NBD).

A systematic literature search was conducted using PubMed and Web of Science up to August 2024, focusing on studies related to SNM treatment for NB or NBD.

An innovative electrical neurostimulation approach to mimic reflexive urination control in spinal cord injury models.

Neurogenic lower urinary tract dysfunction (NLUTD) is a frequent consequence of spinal cord injury (SCI), leading to symptoms that significantly impact quality of life. Although many life-saving techniques are available, current treatment strategies for managing NLUTD still exhibit limitations and drawbacks.

Reasons for Hospital Admission in Individuals With Multiple Sclerosis

Background: Health care utilization is higher in individuals with multiple sclerosis (MS) than in the general population. However, there are limited data on the reasons for their hospital admissions. Our primary objective is to analyze the reasons for the hospitalization of individuals with MS with the goal of identifying preventable causes.

Methods: We conducted a retrospective analysis of a cohort of adults with a confirmed diagnosis of MS admitted to Duke University Hospital between January 2018 and January 2020. This yielded a cohort of 210 individuals. Data were analyzed using descriptive statistics.

Results: The most common reason for admission was urinary tract infection (UTI; 10.3%). The average length of stay was 6.1 days for the individuals with MS vs 5.5 days for the general population. The 30-day readmission rates were 14.9% and 15.5%, respectively. A significant number of admitted patients were not on any disease-modifying therapy (DMT), and no difference in median age was identified between those with a DMT vs those without.

Conclusions: Length of stay and readmission rates were similar to those of the general population in this contemporary cohort. Given the prevalence of bladder dysfunction in MS, it is not surprising that a UTI was the most common reason for admission. Actively addressing management of and techniques for bladder dysfunction may decrease the admission rate for individuals with MS. Though we now have more treatment options for MS, many individuals with the highest health care utilization are not on a DMT. Future research is needed to identify the factors that can be addressed to support these patients and reduce preventable hospitalizations.

Danelvis Paredes, Elijah Lackey, Suma Shah

From the Department of Neurology, Duke University Hospital, Durham, NC.

Source: Danelvis Paredes, Elijah Lackey, Suma Shah. Reasons for Hospital Admission in Individuals With Multiple Sclerosis. Int J MS Care. 2024 Oct 28;26(Q4):302-307. doi: 10.7224/1537-2073.2023-064.

Reduction of Overactive Bladder Medications in Spinal Cord Injury With Self-Administered Neuromodulation: A Randomized Trial.

Our goal was to evaluate if self-administered bladder neuromodulation with transcutaneous tibial nerve stimulation could safely replace overactive bladder medications in people with spinal cord injury.

Summary of the 2024 Update of the European Association of Urology Guidelines on Neurourology

Background and objective: Most patients with neurourological disorders require lifelong medical care. The European Association of Urology (EAU) regularly updates guidelines for diagnosis and treatment of these patients. The objective of this review is to provide a summary of the 2024 updated EAU guidelines on neurourology.

Methods: A structured literature review covering the timeframe 2021-2023 was conducted for the guideline update. A level of evidence and a strength rating were assigned for each recommendation on the basis of the literature data.

Key findings and limitations: Neurological conditions significantly affect urinary, sexual, and bowel function, and lifelong management is required for neurourological patients to maintain their quality of life and prevent urinary tract deterioration. Early diagnosis and effective treatment are key, and comprehensive clinical assessments, including urodynamics, are crucial. Management should be customised to individual needs and should involve a multidisciplinary approach and address sexuality and fertility. Lifelong monitoring and follow-up highlight the importance of continuous care for neurourological patients.

Conclusions and clinical implications: The 2024 EAU guidelines on neurourology provide an up-to-date overview of available evidence on diagnosis, treatment, and follow-up for neurourological patients.

Patient summary: Neurological disorders very frequently affect the lower urinary tract and sexual and bowel function and patients need lifelong management. We summarise the updated European Association of Urology guidelines on neurourology to provide patients and caregivers with the latest insights for optimal health care support.

Andrea M Sartori,1 Thomas M Kessler,2 David M Castro-Díaz,3 Peter de Keijzer,4 Giulio Del Popolo,5 Hazel Ecclestone,6 Dennis Frings,7 Jan Groen,7 Rizwan Hamid,8 Gilles Karsenty,9 Stefania Musco,5 Bárbara Padilla-Fernández,3 Jürgen Pannek,10 Natasha Schouten,4 Angela van der Vorm,4 Bertil F M Blok7

  1. Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, Zürich, Switzerland; Harvard Medical School, Boston, MA, USA; Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
  2. Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, Zürich, Switzerland.
  3. Department of Urology, Complejo Hospitalario Universitario de Canarias, Universidad de La Laguna, Tenerife, Spain.
  4. European Association of Urology Guidelines Office, Arnhem, The Netherlands.
  5. Department of Neuro-urology, Careggi University Hospital, Florence, Italy.
  6. Taranaki District Health Board, New Plymouth, New Zealand.
  7. Department of Urology, Erasmus Medical Center, Rotterdam, The Netherlands.
  8. Department of Neuro-Urology, London Spinal Injuries Centre, Stanmore, UK.
  9. Department of Urology, Aix Marseille University, Marseille, France.
  10. Neuro-Urology Department, Swiss Paraplegic Center, Nottwil, Switzerland; Department of Urology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Source: Sartori A., Kessler T., Castro-Díaz D. et al. Summary of the 2024 Update of the European Association of Urology Guidelines on Neurourology. Eur Urol. 2024 Jun;85(6):543-555. doi: 10.1016/j.eururo.2024.03.026.

Comparative study on the Impact of Transcranial Magnetic stimulation and Bio-feedback on overactive bladder in multiple sclerosis patients: a Randomized Clinical Trial.

Overactive bladder (OAB) is a common clinical presentation in patients with multiple sclerosis.

The purpose of this study was to compare the effects of transcranial magnetic stimulation (TMS) and biofeedback on overactive bladder in patients with multiple sclerosis.

White Matter Magnetic Resonance Diffusion Measures in Multiple Sclerosis with Overactive Bladder.

Lower urinary tract (LUT) symptoms are reported in more than 80% of patients with multiple sclerosis (MS), most commonly an overactive bladder (OAB). The relationship between brain white matter (WM) changes in MS and OAB symptoms is poorly understood.

Real-World Use of Intradetrusor Botulinum Toxin Injections: A Population-Based Study from France.

In recent decades, intradetrusor injections of botulinum toxin A (BoNT-A) have been widely applied to treat incontinence in both idiopathic overactive bladder (iOAB) and neurogenic detrusor overactivity incontinence (NDOI).

Percutaneous Tibial Nerve Stimulation's Impact on Sexual Function in Female Patients with Neurogenic Detrusor Overactivity, Sexual Dysfunction, and Multiple Sclerosis.

Background/Objectives: Multiple sclerosis (MS) frequently results in both urinary and sexual dysfunction, which significantly impairs quality of life. Conventional treatments for bladder dysfunction often prove insufficient, leading to the exploration of alternative therapies such as percutaneous tibial nerve stimulation (PTNS).

The outcomes of robot-assisted surgery in the treatment of neurogenic lower urinary tract dysfunctions: a systematic review and meta-analysis.

To assess the outcomes of robotic surgery for patients with neurogenic lower urinary tract dysfunctions (NLUTD).

Studies evaluating the outcomes (efficacy and safety) of robot-assisted ileal conduit creation or artificial urinary sphincter (R-AUS) implantation or augmentation cystoplasty or continent urinary diversion creation in patients with NLUTD were included.

How Do Surgical Interventions for Neurogenic Lower Urinary Tract Dysfunction Impact Quality of Life?

Adult patients with neurogenic lower urinary tract dysfunction (NLUTD) often have urinary symptoms that impact their quality of life (QOL). Our objective is to identify and summarize studies evaluating QOL changes across different NLUTD surgical interventions.

Intravesical Oxybutynin Treatment for Neurogenic Detrusor Overactivity : Efficacy and Safety Data from Clinical Practice with the First Intravesical Oxybutynin Treatment Authorized in Germany - Beyond the Abstract

Neurogenic detrusor overactivity (NDO) represents a significant functional disorder of the bladder, with the potential for significant morbidity and mortality. This can result in reflux of urine into the upper urinary tract, which may cause renal damage. Patients with NDO frequently experience an increase in micturition frequency, urinary incontinence, residual voiding volume, and urinary tract infections, which collectively result in a reduction in overall quality of life.

Cross-cultural adaptation and psychometric validation of a Chinese self-intermittent catheterization quality of life scale among patients with neurogenic bladder.

Intermittent self-catheterization (ISC) is widely considered the gold standard for treating patients with neurogenic bladder (NB). Healthcare professionals and catheter users must optimize ISC care to improve patients' quality of life.

Response to Treatment with Botulinum Neurotoxin A (BoNT-A) in Children and Adolescents with Neurogenic Lower Urinary Tract Dysfunction and Idiopathic Overactive Bladder: A Systematic Review and Meta-Analysis.

Botulinum neurotoxin A (BoNT-A) is a treatment option for neurogenic lower urinary tract dysfunctions (NLUTD) and idiopathic overactive bladder (OAB) in adults. Recently, its use has gained popularity in paediatric urology.