Summary of European Association of Urology (EAU) Guidelines on Neuro-Urology

Groen, Jan; Pannek, Jürgen; Castro-Díaz, David; Popolo, Giulio Del; Gross, Tobias; Hamid, Rizwan; Karsenty, G.; Kessler, Thomas M.; Schneider, Marc P.; Hoen, Lisette A. ’t; Blok, Bertil

doi:10.1016/j.eururo.2015.07.071

Cited by 449 publications

(509 citation statements)

References 60 publications

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“…So far international management guidelines for urinary disturbances have been developed [15,16], but are not specific for the MS population. The International Scientific Committee of the 5 th International Consultation on Incontinence on 2012 has formulated general recommendations for the diagnosis of neurogenic lower urinary tract dysfunction (NLUTD): a) patients with neurologic disease known to be associated with NLUTD should be evaluated for the presence of lower urinary tract symptoms; b) urodynamic tests should selectively be employed to supplement clinical assessment in determining management in NLUTD; c) sphincter EMG can be valuable in the diagnosis of patients with neurologic bladder dysfunction and can be considered as a diagnostic method in patients with NLUTD and neurologic urinary incontinence [15].…”

Section: Discussionmentioning

confidence: 99%

Discrepancies between urinary symptoms assessment and objective bladder dysfunctions in multiple sclerosis

Haggiag

Bolla

Picconi³

et al. 2017

Mult Scler Demyelinating Disord

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Objective: To assess the association between objective bladder function parameters in relation to urinary symptoms, and to analyze the sensitivity and specificity of subjective urinary symptom-assessment in predicting objective bladder dysfunction in a multiple sclerosis (MS) population. Methods: Consecutive MS patients with Expanded Disability Status Score (EDSS) ≤7.0 were included in this prospective study. In a single visit, patients were evaluated for the presence of urinary symptoms, then assessed for the following urological parameters: maximum urinary flow rate (Qmax), postvoid residual urine volume (PVR), and detrusor sphincter dyssinergia (DSD). Results: One hundred nine subjects were included with a mean disease duration of 12.5 ± 8.7 years, 90.8% had a relapsing-remitting course; the mean EDSS score was 2.6 ± 1.7. Overall, 53.5% complained of at least one urinary symptom, and the most reported one was urgency (40.7%), followed by frequency (15.7%) and incomplete emptying (12.0%). Abnormal values were found for Qmax in 34.9%, for PVR in 40.4% of participants; DSD was diagnosed in 33.9% of the cases. Only Qmax was found negatively associated with the EDSS score (p = 0.007), but no other association was observed. The presence of urinary symptoms was poor predictor of bladder dysfunction, urgency among the others showed relatively higher predicting value. Conclusions: Subjective urinary symptoms assessment failed in predicting bladder function. Our results confirmed the value of objective urological assessment in patients with MS, irrespective of the presence of urinary symptoms.

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Section: Discussionmentioning

confidence: 99%

Discrepancies between urinary symptoms assessment and objective bladder dysfunctions in multiple sclerosis

Haggiag

Bolla

Picconi³

et al. 2017

Mult Scler Demyelinating Disord

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“…A new β-3adrenoreceptor agonist (Mirabegron) has recently been introduced as an option in the treatment of overactive bladder. 7 Improved incontinence and relevant reduction in pad use and daily micturition frequence were observed. 8 Because of the different mechanism of action, and thus the potential of less side effects, this agent seems to be a promising drug also in the treatment of NDO in patients with SCI.…”

Section: Introductionmentioning

confidence: 96%

Initial experience with the treatment of neurogenic detrusor overactivity with a new β-3 agonist (mirabegron) in patients with spinal cord injury

Wöllner

Pannek

2015

Spinal Cord

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Initial experience with the treatment of neurogenic detrusor overactivity with a new β-3 agonist (mirabegron) in patients with spinal cord injury J Wöllner and J PannekStudy design: It is a retrospective chart analysis. Objectives: In patients with neurogenic lower urinary tract dysfunction (NLUTD) due to spinal cord injury (SCI), neurogenic detrusor overactivity (NDO) can cause both deterioration of the upper urinary tract and urinary incontinence. Antimuscarinic treatment is frequently discontinued due to side effects or lack of efficacy, whereas injection of onabotulinumtoxin into the detrusor is a minimally invasive procedure with risks of urinary retention, infection and haematuria. Mirabegron, a new β-3 agonist, is a potential new agent for treatment of NDO. Aim of the study was to evaluate the efficacy of mirabegron in SCI patients with NLUTD. Setting: Swiss Paraplegic Center, Nottwil, Switzerland. Methods: A retrospective chart analysis of SCI patient treated with mirabegron. Results: Fifteen patients with NDO were treated with mirabegron for a period of at least 6 weeks. Significant reduction of the frequency of bladder evacuation per 24 h (8.1 vs 6.4, P = 0.003), and of incontinence episodes per 24 h (2.9 vs 1.3, P = 0.027) was observed. Furthermore, we observed improvements in bladder capacity (from 365 to 419 ml), compliance (from 28 to 45 ml cm − 1 H 2 0) and detrusor pressure during storage phase (45.8 vs 30 cm H 2 0). At follow-up, 9/15 patients were satisfied with the therapy, 4/15 reported side effects (3 × aggravation of urinary incontinence, 1 × constipation). Conclusions: Mirabegron may evolve as an alternative in the treatment of NDO. We observed improvements in urodynamic and clinical parameters. Due to the limited number of patients and the retrospective nature of the study, prospective, placebo-controlled studies are necessary.

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“…The site and nature of the neurological lesion determines the pattern of dysfunction [1,2]. The high prevalence of neurogenic lower urinary tract dysfunction (NLUTD) is reflected by the wide distribution of neural control in health and depends on the underlying neurological disorder, for instance reaching about 25% in patients with Alzheimer's disease and approaching 100% in those suffering from multiple sclerosis at an advanced stage [1,2]. NLUTD substantially impairs quality of life and lower urinary tract function becomes one of the most relevant aspects in daily life of the neuro-urological patient [1,3].…”

Section: Introductionmentioning

confidence: 99%

Transcutaneous Electrical Nerve Stimulation for Treating Neurogenic Lower Urinary Tract Dysfunction: A Systematic Review

et al. 2016

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Summary of European Association of Urology (EAU) Guidelines on Neuro-Urology

Cited by 449 publications

References 60 publications

Discrepancies between urinary symptoms assessment and objective bladder dysfunctions in multiple sclerosis

Discrepancies between urinary symptoms assessment and objective bladder dysfunctions in multiple sclerosis

Initial experience with the treatment of neurogenic detrusor overactivity with a new β-3 agonist (mirabegron) in patients with spinal cord injury

Transcutaneous Electrical Nerve Stimulation for Treating Neurogenic Lower Urinary Tract Dysfunction: A Systematic Review

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