A Comprehensive Review of Common Neurogenic Bladder Disorders

Introduction

Neurourology is a broad term used to describe the study of the interaction between the nervous and genitourinary systems. Indeed, neurourology includes the study of nervous system interactions with the upper urinary tract, lower urinary tract (LUT), as well as its impact on sexual function, which also is frequently affected by neurologic disease.1 Neurogenic bladder (NGB) is a term used frequently to refer to bladders that have become dysfunctional from a variety of sources (such as long-term obstruction). For the purposes of this review, NGB refers only to conditions where a known neurological disease has affected bladder function, a systemic disease that has resulted in neuropathy causing bladder dysfunction, or abnormal urodynamic findings suggestive of neurological disease. In 2002, the International Continence Society (ICS) redefined the terminology of the lower urinary tract, with regards to both symptoms and urodynamic findings. Many of the commonly used terms were replaced such as detrusor instability (idiopathic detrusor overactivity) and detrusor hyperreflexia (neurogenic detrusor overactivity), and the reader is referred to the ICS reference for the full list of nomenclature changes.2 In this review article, we will focus on the neurovesical dysfunction in spinal cord injury (SCI), dementia, Parkinson's disease (PD), and multiple sclerosis (MS).

Abstract

Neurovesical dysfunction is a significant problem facing urologists and patients alike. When dealing with patients who are suffering the social and medical burdens of neurovesical dysfunction, goals of treatment should be aimed at reduction of symptoms, improvement of quality of life, preservation of sexual function, avoidance of symptomatic urinary tract infections, and preservation of upper tract function. The past 20 years has shown much advancement in many of these areas and our urological care of patients with neurological disease. In this review article, we will focus on the neurovesical dysfunction in spinal cord injury (SCI), dementia, Parkinson's disease (PD) and multiple sclerosis (MS).

Keywords

Neurogenic Bladder, Neurovesical Dysfunction, Spinal Cord Injury, Parkinson's Disease, Multiple Sclerosis, Stroke and Dementia