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Clinical guidelines of patient-centered bladder management of neurogenic lower urinary tract dysfunction due to chronic spinal cord injury – Part 3: Surgical treatment in chronic spinal cord injured patients

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Title: Clinical guidelines of patient-centered bladder management of neurogenic lower urinary tract dysfunction due to chronic spinal cord injury – Part 3: Surgical treatment in chronic spinal cord injured patients
Authors: Yu-Hua Lin, Yu-Hua Fan, Chun-Te Wu, Yuan-Chi Shen, Ju-Chuan Hu, Shi-Wei Huang, Po-Ming Chow, Po-Chih Chang, Chun-Hou Liao, Yu-Chen Chen, Victor Chia-Hsiang Lin, Chih-Chen Hsu, Shang-Jen Chang, Chung-Cheng Wang, Wei-Yu Lin, Chih-Chieh Lin, Yuan-Hong Jiang, Hann-Chorng Kuo
Source: Urological Science, Vol 34, Iss 3, Pp 109-116 (2023)
Publisher Information: Wolters Kluwer Health/LWW, 2023.
Publication Year: 2023
Collection: LCC:Diseases of the genitourinary system. Urology
Subject Terms: bladder management, guidelines, lower urinary tract dysfunction, neurogenic bladder, spinal cord injury, surgery, Diseases of the genitourinary system. Urology, RC870-923
More Details: This article reports the current evidence and expert opinions on patient-centered bladder management of neurogenic lower urinary tract dysfunction (NLUTD) among chronic spinal cord injured (SCI) patients in Taiwan. The main problems with SCI-NLUTD are failure to store, empty, or both. The management of SCI-NLUTD should be prioritized as follows: (a) preservation of renal function, (b) freedom from urinary tract infection, (c) efficient bladder emptying, (d) freedom from indwelling catheters, (e) patient agreement with management, and (f) avoidance of medication after proper management. The management of NLUTD in SCI patients must be based on urodynamic findings rather than neurologic evaluation inferences. It is important to identify high-risk patients to prevent renal functional deterioration in those with chronic SCI-NLUTD. Urodynamic studies should be performed on patients with SCI on a regular basis, and any urological complications should be adequately treated. When surgery is required, less invasive and reversible procedures should be considered first, and any unnecessary surgery in the lower urinary tract should be avoided. The most important aspect of treatment is to improve the quality of life in SCI patients with NLUTD. Annual active surveillance of bladder and renal function is required to avoid renal function deterioration and urological complications, particularly in high-risk SCI patients.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1879-5226
Relation: http://www.e-urol-sci.com/article.asp?issn=1879-5226;year=2023;volume=34;issue=3;spage=109;epage=116;aulast=Lin; https://doaj.org/toc/1879-5226
DOI: 10.4103/UROS.UROS_118_22
Access URL: https://doaj.org/article/066278673f354519ba4b3c3c64587e78
Accession Number: edsdoj.066278673f354519ba4b3c3c64587e78
Database: Directory of Open Access Journals
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  Data: This article reports the current evidence and expert opinions on patient-centered bladder management of neurogenic lower urinary tract dysfunction (NLUTD) among chronic spinal cord injured (SCI) patients in Taiwan. The main problems with SCI-NLUTD are failure to store, empty, or both. The management of SCI-NLUTD should be prioritized as follows: (a) preservation of renal function, (b) freedom from urinary tract infection, (c) efficient bladder emptying, (d) freedom from indwelling catheters, (e) patient agreement with management, and (f) avoidance of medication after proper management. The management of NLUTD in SCI patients must be based on urodynamic findings rather than neurologic evaluation inferences. It is important to identify high-risk patients to prevent renal functional deterioration in those with chronic SCI-NLUTD. Urodynamic studies should be performed on patients with SCI on a regular basis, and any urological complications should be adequately treated. When surgery is required, less invasive and reversible procedures should be considered first, and any unnecessary surgery in the lower urinary tract should be avoided. The most important aspect of treatment is to improve the quality of life in SCI patients with NLUTD. Annual active surveillance of bladder and renal function is required to avoid renal function deterioration and urological complications, particularly in high-risk SCI patients.
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