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Chapter 7 - Neurogenic bladder dysfunction: surgical interventional approaches

from Section 2 - Evaluation and management

Published online by Cambridge University Press:  06 December 2010

By
Xavier Gamé ,
Thomas M. Kessler ,
Sohier Elneil  and
Rizwan Hamid
Edited by
Clare J. Fowler ,
Jalesh N. Panicker  and
Anton Emmanuel
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

This chapter describes the different surgical procedures for managing a neurogenic bladder. The procedures include electrical stimulation, bladder and urethral reconstructive surgery, bladder outlet obstruction management and the treatment of stress urinary incontinence. Electrical stimulation to manage bladder dysfunction in patients with neurological disorders has been used since 1950. Electrical stimulation therapies include intravesical electrostimulation, sacral neuromodulation and sacral anterior root stimulation with selective sacral rhizotomy. Cutaneous continent diversions may be performed in neurological patients, mainly in the young myelomeningocele patient or those with spinal cord injury (SCI) who cannot perform clean intermittent self-catheterization (CISC) via the urethra because of congenital abnormalities, urethral pain, obesity, strictures or poor hand mobility. Finally, the chapter describes the suprapubic catheter (SPC), and sphincter surgery, which relieves bladder outlet obstruction due to external urethral sphincter contraction.
Type
Chapter
Information
Pelvic Organ Dysfunction in Neurological Disease
Clinical Management and Rehabilitation
 , pp. 112 - 126
Publisher: Cambridge University Press
Print publication year: 2010

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