Editing CUA: Neurogenic Lower Urinary Tract Dysfunction (2019) (section)

=== Incontinence and urethral damage ===
* '''<span style="color:#ff0000">Urinary incontinence is commonly observed in patients with neurogenic bladder'''
* '''<span style="color:#ff0000">Freedom from indwelling catheters is a priority in the management of neurogenic bladder'''
* Reports on urethral complications from indwelling catheters are scarce, but more common than for patients on CIC
* '''<span style="color:#ff0000">Complications related to an indwelling catheter include:'''
** '''<span style="color:#ff0000">Males:''' 
***'''<span style="color:#ff0000">Urethral strictures'''
***'''<span style="color:#ff0000">False passages'''
***'''<span style="color:#ff0000">Diverticuli'''
***'''<span style="color:#ff0000">Periurethral abscesses'''
***'''<span style="color:#ff0000">Urethrocutaneous fistula'''
***'''<span style="color:#ff0000">Iatrogenic traumatic hypospadias'''
** '''<span style="color:#ff0000">Females:''' 
***'''<span style="color:#ff0000">Urethral dilation'''
***'''<span style="color:#ff0000">Urethral erosion'''
***'''<span style="color:#ff0000">Urethral destruction'''
** '''<span style="color:#ff0000">Potentially serious secondary consequences, such osteitis pubis or non-healing decubiti ulcers can occur from continued urinary leakage'''
* '''Urethral urinary leakage (catheter bypassing) should be addressed by (3):'''
# '''Ruling out bladder stones and infection'''
# '''Avoiding increasing the catheter size'''
# '''Aggressively treating with oral medications or onabotulinumtoxinA injections'''
* '''Patients with indwelling urethral catheters should be offered conversion to a suprapubic catheter in the setting of significant urethral damage and ideally before the urethra has been irreversibly damaged and there is a risk of stress incontinence.'''
* '''Sexuality is adversely affected'''. Side effects from medications and surgeries to treat urinary incontinence may also secondarily cause sexual dysfunction