Review of Current Neurogenic Bladder Best Practices and International Guidelines
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NEUROGENIC BLADDER (C POWELL, SECTION EDITOR)
Review of Current Neurogenic Bladder Best Practices and International Guidelines Uttam K. Mete 1 & Charles R. Powell 2 Accepted: 10 August 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review Current guidelines for neurogenic bladder (NGB) contain contrasting recommendations in several areas. In this review, the current literature published over the last 5 years will be critically evaluated. Recent Findings A number of novel techniques and therapeutic agents have been introduced in the past 5 years or are currently under investigation. Current guidelines do not take these into account. Mirabegron, electromotive onabotulinumtoxin, hydrogel onabotulinumtoxin, progress in neuromodulation (laparoscopic lead implantation, utility in acute and incomplete spinal cord injury (SCI), transrectal neurostimulation, rechargeable MRI-compatible leads and devices), minimally invasive technique and tissue engineering for augmentation cystoplasty (AC), and risk-based surveillance are few of the recent developments in this field. Summary NGB is a major global medical and social problem. Many international guidelines are available to assist the clinician to provide best treatment to this patient population. Many of the guidelines, however, have not been updated and do not take into account new developments. Newer drugs and techniques described in the literature over the last 5 years should influence the established guidelines. It may be time to update some existing guidelines. Keywords Neurogenic bladder (NGB) . Urodynamics . Neurogenic lower urinary tract dysfunction (NLUTD) . Lower urinary tract symptoms (LUTS) . Urinary bladder
Introduction Low pressure storage and efficient emptying are the two main functions of the lower urinary tract and they are regulated by nervous system. Any injury or lesion in the nervous system can lead to dysfunction of the lower urinary tract and this condition is termed as neurogenic bladder (NGB). Several neurologic diseases including SCI (spinal cord injury), SB (spina bifida), MS (multiple sclerosis), PD (Parkinson’s disease), CP (cerebral palsy), CVA (cerebrovascular accident), This article is part of the Topical Collection on Neurogenic Bladder * Uttam K. Mete [email protected] Charles R. Powell [email protected] 1
Department of Urology, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
2
Indiana University School of Medicine, Indianapolis, IN, USA
and TBI (traumatic brain injury) may lead to NLUTD (neurogenic lower urinary tract dysfunction). This frequently has a negative impact on the patients’ health-related quality of life (QOL). In some cases, bladder dysfunction may precede the onset of neurologic disease (cauda equina, spina bifida occulta) and in some situations bladder dysfunction is manifested at the advanced stage of the neurologic disease (MS). Treatment is largely tailored for preservation of renal function, promotion of continence, prevention o
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