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Chapter 4 - Approach and evaluation of neurogenic bladder dysfunction

from Section 2 - Evaluation and management

Published online by Cambridge University Press:  06 December 2010

Clare J. Fowler
Affiliation:
The National Hospital for Neurology and Neurosurgery, Queen's Square, London
Jalesh N. Panicker
Affiliation:
The National Hospital for Neurology and Neurosurgery, Queen's Square, London
Anton Emmanuel
Affiliation:
University College London
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Summary

Lower urinary tract dysfunction (LUTD) can result from a wide range of neurological conditions. This chapter provides the clinician with an approach to neurogenic bladder dysfunction based on the history, physical examination and investigations, in order to optimize patient management and follow-up. Classification helps with understanding the functional disturbances occurring in neurogenic LUTD. Understanding the underlying dysfunction is paramount before starting treatment. History-taking should address potential dysfunction in both the storage and voiding phases of micturition. Several symptom scales have been validated for the evaluation of urinary disorders, but none are specific for neurogenic LUTD. Physical examination should include neurological, urological, gynecological, abdominal and rectal examination. History, bladder diary and clinical examination may not always be sufficient for understanding the nature of LUTD. Urodynamic tests involve functional and dynamic assessment of the lower urinary tract and are used to assess detrusor and bladder outlet function.
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Chapter
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Pelvic Organ Dysfunction in Neurological Disease
Clinical Management and Rehabilitation
, pp. 61 - 78
Publisher: Cambridge University Press
Print publication year: 2010

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