A Framework for Addressing Health Disparities in Adult Neurogenic Lower Urinary Tract Dysfunction —Systematic Review and Neurogenic Bladder Research Group Recommendations
This report calls for a shift in focus from traditional urologic care to a broader, more inclusive perspective that accounts for the complex interplay of social, economic, and health care factors in managing NLUTD. (Source: Urologic Clinics of North America)
Source: Urologic Clinics of North America - March 12, 2024 Category: Urology & Nephrology Authors: Shanice Cox, Taiwo Dodo-Williams, Brandee Branche, Natalia Garc ía-Peñaloza, Mayra Lucas, Yahir Santiago-Lastra, Neurogenic Bladder Research Group Source Type: research
Erratum
An article in the November 2023 issue of Urologic Clinics of North America (50:4) has an incorrect title. Please note that “Management of Urologic Complications After Genital Gender-Affirming Surgery in Transgender and Nonbinary Patients” by R. Craig Sineath, Finn Hennig, Geolani W. Dy should be correctly listed as “Current State of Urology Residency Education on Caring for Transgender and Non-Binary Patients” b y R. Craig Sineath, Finn Hennig, Geolani W. Dy. (Source: Urologic Clinics of North America)
Source: Urologic Clinics of North America - March 12, 2024 Category: Urology & Nephrology Source Type: research
Bladder-Related Quality of Life After Spinal Cord Injury
The Neurogenic Bladder Research Group (NBRG) was formed with the mission to optimize quality of life (QoL), surgical outcomes, and clinical care of patients with neurogenic lower urinary tract dysfunction. One of the original priorities of the organization was to support creation of the NBRG Spinal Cord Injury (SCI) Registry. The aim of this Registry was to establish a prospective database, in order to study bladder-related QoL after SCI. The study enrolled close to 1500 participants from across North America over an 18 month time-period (January 2016 –July 2017). (Source: Urologic Clinics of North America)
Source: Urologic Clinics of North America - March 11, 2024 Category: Urology & Nephrology Authors: Jeremy B. Myers, Jane T. Kurtzman Source Type: research
Sleep and Overactive Bladder in Parkinson ’s Disease
Patients with Parkinson ’s disease (PD) have disturbances in their bladder and sleep physiology that lead to nocturia and overactive bladder (OAB). These symptoms can be extremely bothersome and impact not only their quality of life (QoL) but also the QoL of their caretakers. We aim to highlight the changes in bladder an d sleep physiology in PD and explore OAB/nocturia treatment strategies in this population. (Source: Urologic Clinics of North America)
Source: Urologic Clinics of North America - March 9, 2024 Category: Urology & Nephrology Authors: Yu Zheng, Anne P. Cameron Source Type: research
The Ideal Neurogenic Bladder Management Team
This article discusses the ideal neurogenic bladder management team for patients who have neurogenic lower urinary tract dysfunction (NLUTD). It emphasizes the importance of a diverse team, including urologists, physiatrists, neurologist and others, working collaboratively to prevent complications and enhance patient outcomes. Owing to the unique nuances of the various neurologic conditions and patterns of NLUTD dysfunction, the roles of different specialists in the interdisciplinary team are outlined. This article describes 3 team models: multidisciplinary, interdisciplinary, and transdisciplinary, highlighting the benefi...
Source: Urologic Clinics of North America - March 9, 2024 Category: Urology & Nephrology Authors: LaTanya Lofton Hogue, Michael Kennelly Source Type: research
An Overview of the Effect of Aging on the Female Urethra
Urethral function declines by roughly 15% per decade and profoundly contributes to the pathogenesis of urinary incontinence. Individuals with poor urethral function are more likely to fail surgical management for stress incontinence that focus on improving urethral support. The reduced number of intramuscular nerves and the morphologic changes in muscle and connective tissue collectively impact urethral function as women age. Imaging technologies like MRI and ultrasound have advanced our understanding of these changes. However, substantial knowledge gaps remain. Addressing these gaps can be crucial for developing better pr...
Source: Urologic Clinics of North America - March 8, 2024 Category: Urology & Nephrology Authors: Andrew S. Afyouni, Yi Xi Wu, Ulysses G.J. Balis, John DeLancey, Zhina Sadeghi Source Type: research
Integrating Patient Preferences with Guideline-Based Care in Neurogenic Lower Urinary Tract Dysfunction After Spinal Cord Injury
Individual and social factors are important for clinical decision-making in patients with neurogenic bladder secondary to spinal cord injury (SCI). These factors include the availability of caregivers, social infrastructure, and personal preferences, which all can drive bladder management decisions. These elements can be overlooked in clinical decision-making; therefore, there is a need to elicit and prioritize patient preferences and values into neurogenic bladder care to facilitate personalized bladder management choices. For the purposes of this article, we review the role of guideline-based care and shared decision-mak...
Source: Urologic Clinics of North America - March 7, 2024 Category: Urology & Nephrology Authors: Vivian Wong, Giulia M. Ippolito, Irene Crescenze Source Type: research
Voiding Phase Dysfunction in Multiple Sclerosis
Lower urinary tract symptoms (LUTS) are highly prevalent in individuals with multiple sclerosis (MS). However, assessment of these symptoms is often hindered by vague definitions or absence of screening in asymptomatic patients. It is crucial to exercise caution when applying the non-neurogenic definition of urinary retention in this population. For men with MS experiencing persistent and treatment-resistant LUTS, urodynamic studies should be used to identify the underlying causes of symptoms. Although numerous therapies are presently accessible for managing LUTS in MS, there is a need for further investigation into emergi...
Source: Urologic Clinics of North America - March 4, 2024 Category: Urology & Nephrology Authors: Catherine Frances Ingram, John A. Lincoln, Rose Khavari Source Type: research
Barriers to Transitional Care in Spina Bifida
This article reviews key aspects of the care of patients with spina bifida, the impact of inadequate transition to adult care, barriers to transition, and offers a potential vision for the future. (Source: Urologic Clinics of North America)
Source: Urologic Clinics of North America - February 28, 2024 Category: Urology & Nephrology Authors: Catalina K. Hwang, Kelly T. Harris, Dan Wood Source Type: research
Neurogenic Bladder: A Complex Puzzle with Multiple Pieces
What is a neurogenic bladder? If we use a definition, neurogenic bladder is broadly defined as any bladder function that is impacted by a neurologic condition. However, this definition suffers when trying to describe a “typical” or “index” person with a neurogenic bladder. It could describe a person with multiple sclerosis–impacted urinary incontinence from neurologically derived detrusor overactivity. Or it could be a spinal cord–injured person performing intermittent catheterization for urinary reten tion related to detrusor underactivity. (Source: Urologic Clinics of North America)
Source: Urologic Clinics of North America - February 27, 2024 Category: Urology & Nephrology Authors: John T. Stoffel Tags: Preface Source Type: research
Detrusor Sphincter Dyssynergia
Detrusor sphincter dyssynergia (DSD) is defined as a detrusor contraction concurrent with an involuntary contraction of the urethral and/or periurethral striated muscles typically occurring in a patient with a spinal cord lesion above the sacral cord. Consequently, high urethral closure pressures during the detrusor contraction leads to high intravesical voiding pressure and large postvoid residuals, which can lead to significant complications in up to 50% of patients if DSD is not treated and followed-up regularly. DSD treatment options are centered around symptomatic management rather that addressing the underlying causa...
Source: Urologic Clinics of North America - February 19, 2024 Category: Urology & Nephrology Authors: Marc A. Furrer, Thomas M. Kessler, Jalesh N. Panicker Source Type: research
The Role of Upper Extremity Motor Function in the Choice of Bladder Management in Those Unable to Volitionally Void due to Neurologic Dysfunction
It is estimated that 425,000 individuals with neurologic bladder dysfunction (spinal cordinjury, spina bifida and multiple sclerosis) are unable to volitionally void and must rely oncatheter drainage. Upper extremity (UE) motor function is one of the most important factors indetermining the type of bladder management chosen in individuals who cannot volitionally void. Novel bladder management solutions for those with impaired UE motor function and concurrent impairments involitional voiding continue to be an area of need. Those with poor UE motor function more often choose an indwelling catheter, whereas those with normal ...
Source: Urologic Clinics of North America - February 17, 2024 Category: Urology & Nephrology Authors: Michael Juszczak, Kazuko Shem, Christopher S. Elliott Source Type: research
Urinary Catheters
Urinary catheters have been used for more than 3000 years, although materials have changed from wood to silver to rubber. Research continues to try and find the optimal catheter materials, which improve safety and quality of life. Advantages when comparing newer catheter materials are not always obvious but catheters coated with a hydrophilic layer may reduce urethral trauma and the incidence of urinary tract infections. However, extrapolation of the data is limited by lack of end-point standardization and heterogenous populations. (Source: Urologic Clinics of North America)
Source: Urologic Clinics of North America - February 9, 2024 Category: Urology & Nephrology Authors: John T. Stoffel, Lisa Yu Source Type: research
Questionnaires for Neurogenic Lower Urinary Tract Dysfunction
This article discusses how to measure QOL and urinary symptoms in NLUTD and highlights various questionnaires such as the Qualiveen, Neurogenic Bladder Symptom Score (NBSS), and the Incontinence Quality of Life Questionnaire (I-QOL). These questionnaires focus on bladder-related QOL or symptoms and have been validated in multiple NLUTD populations. These tools are important for advancing research and the clinical care of NLUTD patients, and have the potential to impact decision-making and improve patient outcomes. (Source: Urologic Clinics of North America)
Source: Urologic Clinics of North America - February 6, 2024 Category: Urology & Nephrology Authors: Blayne Welk Source Type: research
Bladder Compliance
Bladder compliance is the relationship between detrusor pressure and bladder storage volume. We discuss the definition of compliance, how it may be accurately measured, and its clinical relevance. Specifically, we discuss the association between low compliance and upper urinary tract deterioration. We discuss medical and surgical therapies that have been demonstrated to improve compliance and reduce upper tract risk. Finally, we propose a model, which not only considers compliance but also differential pressure between the bladder and ureters, and how this may also be an accurate predictor of upper tract deterioration. We ...
Source: Urologic Clinics of North America - January 6, 2024 Category: Urology & Nephrology Authors: Glenn T. Werneburg, John T. Stoffel Source Type: research
