CUA: Neurogenic Lower Urinary Tract Dysfunction (2019): Difference between revisions
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*#*# '''<span style="color:#ff0000">Known high-risk features''' | *#*# '''<span style="color:#ff0000">Known high-risk features''' | ||
*#*# '''<span style="color:#ff0000">Considering more invasive treatment options''' | *#*# '''<span style="color:#ff0000">Considering more invasive treatment options''' | ||
*'''See [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6570608/figure/f2-cuaj-6-e157/ Figure 2] (Initial investigations and risk stratification for neurogenic lower urinary tract dysfunction (NLUTD) patients) from Original Guideline''' | |||
=== History and Physical Exam === | === History and Physical Exam === | ||
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==== '''Validated questionnaires''' ==== | ==== '''Validated questionnaires''' ==== | ||
* Optional | * '''Optional''' | ||
*Generally used for research purposes in the NLUTD population | |||
'''Cystoscopy''' | '''Cystoscopy''' | ||
* Should be reserved for situations where there is a clinical indication to assess either the urethra or bladder (such as suspicion of urethral strictures or false passages, bladder stones, or bladder cancer) | * Should be reserved for situations where there is a clinical indication to assess either the urethra or bladder (such as suspicion of urethral strictures or false passages, bladder stones, or bladder cancer) | ||
=== Timing === | === Timing === | ||
*''' | *'''Depends on the severity of symptoms, underlying risk of serious urological complications, and the etiology of the neurogenic bladder.''' | ||
** '''SB and SCI have a significant risk of renal dysfunction and are acquired at birth (SB) or often as young adults (SCI); this makes patients particularly susceptible to renal dysfunction in their lifetime. This contrasts with slowly progressive diseases, such as relapsing-remitting MS, or the predominately elderly population with Parkinson’s disease or dementia.''' | ** '''SB and SCI have a significant risk of renal dysfunction and are acquired at birth (SB) or often as young adults (SCI); this makes patients particularly susceptible to renal dysfunction in their lifetime. This contrasts with slowly progressive diseases, such as relapsing-remitting MS, or the predominately elderly population with Parkinson’s disease or dementia.''' | ||
** '''The urological evaluation of a patient with a newly acquired SCI should occur within 3–6 months of the SCI.''' | ** '''The urological evaluation of a patient with a newly acquired SCI should occur within 3–6 months of the SCI.''' | ||
*** Significant bladder dysfunction can appear early after SCI. Efforts should made to assess patients with urological complications or concerns as soon as possible after the acute SCI. | *** Significant bladder dysfunction can appear early after SCI. Efforts should made to assess patients with urological complications or concerns as soon as possible after the acute SCI. | ||
== Management == | == Management == | ||