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  • Review Article
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The management of neurogenic lower urinary tract dysfunction after spinal cord injury

Nature Reviews Urology volume 13, pages 705–714 (2016)Cite this article

Subjects

Key Points

  • Management decisions based purely on pure anatomical and/or neurological findings should be supplemented by greater attention to the quality of life of each patient with SCI, in a culturally sensitive way

  • The exact nature of neurogenic dysfunctions of the bladder, bladder neck and sphincter, and their coordinated function are specific in each individual patient

  • Diagnosis should be made after taking into account all available clinical data, including data from specific tests

  • Bladder management should form a part of the comprehensive management of a patient with SCI

  • Treatment should be conservative, and surgical techniques should be reserved for patients with a high risk of a loss of renal function, urinary incontinence and infection, despite proper use of conservative approaches

Abstract

The management of patients with neurogenic bladder has changed substantially over the past decades. Obtaining balanced lower urinary tract function has become possible in most patients, although, urological complications remain among the most serious complications these patients are likely to have and, even today, these can have a negative effect on quality of life. To this extent, patients with spinal cord injury (SCI) are likely to develop neurogenic bladder, and data are available on most aspects of neurogenic bladder in these patients. Data on physiology and pathophysiology form the basis of our understanding of patients' symptoms, and also provide a basis for the management of these patients. The use of conservative, and/or more invasive treatment measures, their complications and measures to prevent these complications, are all important clinical aspects that merit discussion. Considerable progress has been made in the urological management of patients with SCI over the past decades, but opportunities remain to make diagnosis more accurate and therapy more successful.

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Figure 1: Types of bladder dysfunction typically observed after spinal cord injury.
Figure 2: The combination of functional and anatomical urodynamic data.

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  1. University of Antwerp, Antwerp, SIRATE32 GCV, Bredabaan 32, Brasschaat, 2930, Belgium

    Jean-Jacques Wyndaele

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Correspondence to Jean-Jacques Wyndaele.

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Wyndaele, JJ. The management of neurogenic lower urinary tract dysfunction after spinal cord injury. Nat Rev Urol 13, 705–714 (2016). https://doi.org/10.1038/nrurol.2016.206

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