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Radek Kaiser, Luigi Aurelio Nasto, Murali Venkatesan, Petr Waldauf, Belen Perez, Oliver M Stokes, Sleiman Haddad, Hossein Mehdian, Magnum Tsegaye
BACKGROUND: Timing of surgery and the importance of the size of disc prolapse in cauda equina syndrome (CES) remain controversial. OBJECTIVE: To investigate whether there is a relationship between postoperative urinary function, preoperative duration of neurogenic lower urinary tract dysfunction (NLUTD), and the level of canal compromise. METHODS: Seventy-one patients operated for CES were prospectively identified between 2010 and 2013. Fifty-two cases with preoperative NLUTD were included...
February 6, 2018: Neurosurgery
Stefania Musco, Barbara Padilla-Fernández, Giulio Del Popolo, Matteo Bonifazi, Bertil F M Blok, Jan Groen, Lisette 't Hoen, Jürgen Pannek, Jerome Bonzon, Thomas M Kessler, Marc P Schneider, Tobias Gross, Gilles Karsenty, Véronique Phé, Rizwan Hamid, Hazel Ecclestone, David Castro-Diaz
AIM: The main goals of neurogenic lower urinary tract dysfunction (NLUTD) management are preventing upper urinary tract damage (UUTD), improving continence, and quality of life. Here, we aimed to systematically assess all available evidence on urodynamics predicting UUTD in patients with NLUTD. METHODS: A systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement was performed in March 2017. Only neuro-urological patients assessed by urodynamics were included...
February 2, 2018: Neurourology and Urodynamics
Mirjam Bywater, Jure Tornic, Ulrich Mehnert, Thomas M Kessler
PURPOSE: We assessed urodynamic parameters within the first 40 days after spinal cord injury (SCI) investigating whether the detrusor is acontractile during the acute phase of SCI. PATIENTS AND METHODS: We performed a prospective cohort study including 54 patients with neurogenic lower urinary tract dysfunction (NLUTD) due to acute SCI undergoing urodynamic investigation (UDI) within the first 40 days after injury at a single university SCI center. RESULTS: and Limitations: Of the 54 patients, UDI revealed an acontractile detrusor in only 20 (37%) but unfavorable urodynamic parameters in a total of 34 (63%) patients...
January 15, 2018: Journal of Urology
Paolo DI Benedetto, Enrico Finazzi-Agrò
Neurogenic lower urinary tract dysfunction (NLTUD) is commonly encountered in neuro-rehabilitation settings and is caused by a variety of pathologies. The management of spinal cord injury (SCI) has been the model of reference for the approach to NLTUD due to many other diseases of the central and peripheral nervous system. The decline in renal-related mortality in SCI patients after the introduction of clean intermittent catheterization in association with pharmacological treatment (antimuscarinics in particular), and the algorithms proposed since 1998 by the International Consultations on Incontinence underline the need of early assessment and treatment of urinary incontinence and/or urinary retention in neuropathic patients...
December 2017: European Journal of Physical and Rehabilitation Medicine
Jürgen Pannek, Jens Wöllner
INTRODUCTION: Urinary tract infections (UTIs) are one of the most common morbidities in persons with neurogenic lower urinary tract dysfunction (NLUTD). They are associated with a significant morbidity and mortality, and they affect the quality of life of the affected patients. Diagnosis and treatment of UTI in this group of patients are challenging. In this review, the current strategies regarding diagnosis, treatment, and prevention are summarized. DIAGNOSTICS: it is important to correctly diagnose a UTI, as treatment of bacteriuria should strictly be avoided...
2017: Research and Reports in Urology
Marko Kozomara, Ulrich Mehnert, Burkhardt Seifert, Thomas M Kessler
PURPOSE: We investigated whether detrusor contraction during rapid bladder filling is provoked by cold or warm water. MATERIALS AND METHODS: Patients with neurogenic lower urinary tract dysfunction were included in this randomized, controlled, double-blind trial. At the end of a standard urodynamic investigation patients underwent 2 bladder fillings using a 4C ice water test or a 36C warm water test saline solution at a filling speed of 100 ml per minute. The order was randomly selected, and patients and investigators were blinded to the order...
July 25, 2017: Journal of Urology
N Brownrigg, L H Braga, M Rickard, F Farrokhyar, B Easterbrook, A Dekirmendjian, K Jegatheeswaran, J DeMaria, A J Lorenzo
INTRODUCTION: Bladder and bowel dysfunction (BBD) can negatively impact the quality of life (QoL) of children. Urotherapy is an accepted treatment option for BBD; however, literature that examines the impact of management options on QoL in this population is scarce. OBJECTIVE: To determine whether a bladder training video (BTV) is non-inferior to standard urotherapy (SU) in improving QoL in children with BBD. METHODS: Children aged 5-10 years and who scored ≥11 on the Vancouver Non-Neurogenic Lower Urinary Tract Dysfunction/Dysfunctional Elimination Syndrome Questionnaire (NLUTD/DES) were recruited from a pediatric tertiary care center...
August 2017: Journal of Pediatric Urology
Ronak A Gor, Sean P Elliott
Surgery for patients with neurogenic urinary tract dysfunction (nLUTD) is indicated when medical therapy fails, to correct conditions affecting patient safety, or when surgery can enhance the quality of life better than nonoperative management. Examples include failure of maximal medical therapy, inability to perform or aversion to clean intermittent catheterization, refractory incontinence, and complications from chronic, indwelling catheters. Adults with nLUTD have competing risk factors, including previous operations, obesity, poor nutritional status, complex living arrangements, impaired dexterity/paralysis, and impaired executive and cognitive function...
August 2017: Urologic Clinics of North America
Paholo G Barboglio Romo, Priyanka Gupta
Sacral and peripheral neuromodulation are minimally invasive surgical procedures that are third-line therapy options for the treatment of patients with idiopathic overactive bladder syndrome. There has been interest in their efficacy in the management of neurogenic lower urinary tract dysfunction (NLUTD). Contemporary data suggest promising outcomes for urinary and bowel symptoms in carefully selected patients with spinal cord injury and/or multiple sclerosis. This article reviews the current literature regarding urinary and bowel outcomes in patients with NLUTD and also discusses contemporary studies that suggest that treatment during particular stages of neurologic injury may prevent long-term urinary sequelae...
August 2017: Urologic Clinics of North America
Randy A Vince, Adam P Klausner
Patients with neurogenic lower urinary tract dysfunction (NLUTD) experience significant morbidity and mortality due to urological complications including upper tract damage and bladder malignancy. This has led to increased surveillance in patients NLUTD. This article discusses the methods available for surveillance of patients with NLUTD and pulls information from the largest and most established organizations that have produced evidence-based surveillance guidelines for NLUTD. These organizations include the Paralyzed Veterans of America (PVA), US Department of Veterans Affairs, European Association of Urology (EAU), The NICE organization from the UK, and cites additional literature not been included in these documents...
August 2017: Urologic Clinics of North America
Shu-Yu Wu, Yuan-Hong Jiang, Hann-Chorng Kuo
PURPOSE: Augmentation enterocystoplasty (AE) has been shown to improve clinical symptoms in patients with end-stage bladder disease (ESBD). Herein, we report the long-term outcomes of a series of patients with different etiologies of ESBD who received AE. METHODS: We retrospectively reviewed 102 patients with ESBD who received AE at the Hualien Tzu Chi General Hospital from 1992 to 2014. ESBD in this study was defined as including neurogenic lower urinary tract dysfunction (NLUTD) due to spinal cord injury (SCI) or myelomeningocele, inflammatory bladder disease (IBD), ESBD occurring after pelvic cancer surgery, and other etiologies...
June 2017: International Neurourology Journal
Véronique Phé, Marc P Schneider, Benoit Peyronnet, Nadim Abo Youssef, Livio Mordasini, Emmanuel Chartier-Kastler, Lucas M Bachmann, Thomas M Kessler
AIMS: To systematically assess all available evidence on efficacy and safety of vanilloids for treating neurogenic lower urinary tract dysfunction (NLUTD) in patients with multiple sclerosis (MS). METHODS: This systematic review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Studies were identified by electronic search of Cochrane register, Embase, Medline, Scopus, (last search January 8, 2016)...
June 15, 2017: Neurourology and Urodynamics
Jerzy B Gajewski, Peter F W M Rosier, Sajjad Rahnama'i, Paul Abrams
INTRODUCTION: Urethral function, as well as anatomy, play a significant role in voiding reflex and abnormalities in one or both contribute to the pathophysiology of Lower Urinary Tract Dysfunction (LUTD). We have several diagnostic tools to assess the urethral function or dysfunction but the question remains, are these adequate? METHODS: This is a report of the proceedings of Think Tank P1: 'Do we assess urethral function adequately in LUTD and NLUTD?' from the annual International Consultation on Incontinence-Research Society, which took place September 22-24, 2014 in Bristol, UK...
April 2017: Neurourology and Urodynamics
Benjamin V Ineichen, Marc P Schneider, Martin Hlavica, Niels Hagenbuch, Michael Linnebank, Thomas M Kessler
BACKGROUND: Neurogenic lower urinary tract dysfunction (NLUTD) is very common in patients with multiple sclerosis (MS), and it might jeopardize renal function and thereby increase mortality. Although there are well-known urodynamic risk factors for upper urinary tract damage, no clinical prediction parameters are available. OBJECTIVE: We aimed to assess clinical parameters potentially predicting urodynamic risk factors for upper urinary tract damage. METHODS: A consecutive series of 141 patients with MS referred from neurologists for primary neuro-urological work-up including urodynamics were prospectively evaluated...
March 1, 2017: Multiple Sclerosis: Clinical and Laboratory Research
R Böthig, B Domurath, A Kaufmann, J Bremer, W Vance, I Kurze
BACKGROUND: Most patients with spinal cord injury (SCI) suffer from neurogenic lower urinary tract dysfunction (NLUTD), bowel dysfunction and sexual dysfunction. If these remain untreated, severe medical complications and serious limitations (restrictions) in quality of life are imminent. OBJECTIVES: In the long term, there are considerable differences in the treatment results of highly specialized centers versus other treatment facilities. MATERIALS AND METHODS: Against this background, a consensus-based guideline, according to the AWMF (Association of the Scientific Medical Societies in Germany) criteria (S2k), was developed by the neuro-urology working group of the DMPG (German-Speaking Medical Society of Paraplegia)...
June 2017: Der Urologe. Ausg. A
Petros Georgopoulos, Apostolos Apostolidis
PURPOSE OF REVIEW: This review aims to analyze and discuss all recently published articles associated with neurogenic voiding discussion providing readers with the most updated knowledge and trigger for further research. RECENT FINDINGS: They include the proposal of a novel classification system for the pathophysiology of neurogenic lower urinary tract dysfunction (NLUTD) which combines neurological defect in a distinct anatomic location, and data on bowel dysfunction, autonomic dysreflexia and urine biomarkers; review of patient-reported outcome measures in NLUTD; review of the criteria for the diagnosis of clinically significant urinary infections; novel research findings on the pathophysiology of NLUTD; and review of data on minimally and more invasive treatments...
May 2017: Current Opinion in Urology
Nadim Abo Youssef, Marc P Schneider, Livio Mordasini, Benjamin V Ineichen, Lucas M Bachmann, Emmanuel Chartier-Kastler, Jalesh N Panicker, Thomas M Kessler
OBJECTIVES: To review systematically all the available evidence on efficacy and safety of cannabinoids for treating neurogenic lower urinary tract dysfunction (NLUTD) in patients with multiple sclerosis (MS). PATIENTS AND METHODS: The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Studies were identified by electronic search of the Cochrane register, Embase, Medline, Scopus (last search on 11 November 2016)...
April 2017: BJU International
J Bremer, R Böthig, B Domurath, J Kutzenberger, A Kaufmann, J Pretzer, J P Klask, V Geng, W Vance, I Kurze
BACKGROUND: The provision of urological appliances for patients with neurogenic lower urinary tract dysfunction (NLUTD) is essential. Hitherto existing standard guidelines for the estimation of monthly material requirements are based solely on estimates. OBJECTIVE: The goal of this work was to define the objective and subsequently subjective requirements for urological appliances on a scientifically validated basis. MATERIALS AND METHODS: Data concerning bladder management and daily consumption of urological appliances for patients with NLUTD were collected through a standardized survey at six different centers in Germany during the period of October to December 2014 and statistically evaluated...
December 2016: Der Urologe. Ausg. A
Rose Khavari, Christof Karmonik, Michael Shy, Sophie Fletcher, Timothy Boone
PURPOSE: Neurogenic lower urinary tract dysfunction, which is common in patients with multiple sclerosis, has a significant impact on quality of life. In this study we sought to determine brain activity processes during the micturition cycle in female patients with multiple sclerosis and neurogenic lower urinary tract dysfunction. MATERIALS AND METHODS: We report brain activity on functional magnetic resonance imaging and simultaneous urodynamic testing in 23 ambulatory female patients with multiple sclerosis...
February 2017: Journal of Urology
Stephanie C Knüpfer, Susanne A Schneider, Mareike M Averhoff, Carsten M Naumann, Günther Deuschl, Klaus-Peter Jünemann, Moritz F Hamann
BACKGROUND: To assess the efficacy and safety of intradetrusor onabotulinumtoxinA (OnabotA) injection treatment in patients with neurogenic lower urinary tract dysfunction (NLUTD), especially for patients with Parkinson disease (PD). METHODS: PD patients refractory to oral antimuscarinic participated in an off-label use study and were evaluated prior and after 200 IU OnabotA injection into detrusor muscle, including trigone. Changes due to treatment were evaluated using bladder diaries, urodynamics, and questionnaires...
September 5, 2016: BMC Urology
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