CUA: Neurogenic Lower Urinary Tract Dysfunction (2019): Difference between revisions
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== Genitourinary sequelae of NLUTD == | == Genitourinary sequelae of NLUTD == | ||
* '''SUSU VIU''' | * '''<span style="color:#0000ff">SUSU VIU''' | ||
# '''S<span style="color:#ff0000">epsis''' | # '''<span style="color:#0000ff">S</span><span style="color:#ff0000">epsis''' | ||
# '''U<span style="color:#ff0000">TIs''' | # '''<span style="color:#0000ff">U</span><span style="color:#ff0000">TIs''' | ||
#* '''The Enterobacteriaceae family represents the most commonly isolated organism in the NLUTD population, with E.coli comprising 50% of all strains.''' | #* '''The Enterobacteriaceae family represents the most commonly isolated organism in the NLUTD population, with E.coli comprising 50% of all strains.''' | ||
#** '''This is a lower than non-neurogenic UTIs, partly explained by the increased incidence of Pseudomonas, Acinetobacter, Enterococcus, and fungi such as Candida''' | #** '''This is a lower than non-neurogenic UTIs, partly explained by the increased incidence of Pseudomonas, Acinetobacter, Enterococcus, and fungi such as Candida''' | ||
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#* '''Antimicrobial prophylaxis''' | #* '''Antimicrobial prophylaxis''' | ||
#** '''Routine antimicrobial prophylaxis for NLUTD UTI is not recommended for most patients''' | #** '''Routine antimicrobial prophylaxis for NLUTD UTI is not recommended for most patients''' | ||
# '''S<span style="color:#ff0000">tones''' | # '''<span style="color:#0000ff">S</span><span style="color:#ff0000">tones''' | ||
# '''U<span style="color:#ff0000">reteric obstruction''' | # '''<span style="color:#0000ff">U</span><span style="color:#ff0000">reteric obstruction''' | ||
#* In some cases, high storage pressure results in prolonged compression of the ureteric orifices, leading to obstructed urine outlet during a prolonged period and, consequently, renal damage. | #* In some cases, high storage pressure results in prolonged compression of the ureteric orifices, leading to obstructed urine outlet during a prolonged period and, consequently, renal damage. | ||
# '''V<span style="color:#ff0000">esicoureteral reflux''' | # '''<span style="color:#0000ff">V</span><span style="color:#ff0000">esicoureteral reflux''' | ||
# '''I<span style="color:#ff0000">ncontinence and urethral damage''' | # '''<span style="color:#0000ff">I</span><span style="color:#ff0000">ncontinence and urethral damage''' | ||
#* '''Urinary incontinence is commonly observed in patients with neurogenic bladder''' | #* '''Urinary incontinence is commonly observed in patients with neurogenic bladder''' | ||
#* '''Freedom from indwelling catheters is a priority in the management of neurogenic bladder''' | #* '''Freedom from indwelling catheters is a priority in the management of neurogenic bladder''' | ||
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#* '''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.''' | #* '''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 | #* '''Sexuality is adversely affected'''. Side effects from medications and surgeries to treat urinary incontinence may also secondarily cause sexual dysfunction | ||
# '''U<span style="color:#ff0000">pper urinary tract deterioration (UUTD)''' | # '''<span style="color:#0000ff">U</span><span style="color:#ff0000">pper urinary tract deterioration (UUTD)''' | ||
#* CKD rates vary from 0.6–3.3% for MS, 1.3–5.6% for SCI, and up to 8% for SB patients, which is higher than that of the general population | #* CKD rates vary from 0.6–3.3% for MS, 1.3–5.6% for SCI, and up to 8% for SB patients, which is higher than that of the general population | ||
#* The pathophysiology of CKD in neurogenic bladder is not well-understood | #* The pathophysiology of CKD in neurogenic bladder is not well-understood | ||