Neurogenic Bladder: Epidemiology, Diagnosis, and Management

Lower urinary tract dysfunction is a common sequel of neurological disease resulting in symptoms that significantly impacts quality of life. The site of the neurological lesion and its nature influence the pattern of dysfunction. The risk for developing upper urinary tract damage and renal failure is considerably lower in patients with slowly progressive nontraumatic neurological disorders, compared with those with spinal cord injury or spina bifida. This acknowledged difference in morbidity is considered when developing appropriate management algorithms. The preliminary evaluation consists of history taking, and a bladder diary and may be supplemented by tests such as uroflowmetry, post-void residual measurement, renal ultrasound, (video-)urodynamics, neurophysiology, and urethrocystoscopy, depending on the clinical indications. Incomplete bladder emptying is most often managed by intermittent catheterization, and storage dysfunction is managed by antimuscarinic medications. Intra-detrusor injections of onabotulinumtoxinA have revolutionized the management of neurogenic detrusor overactivity. Neuromodulation offers promise for managing both storage and voiding dysfunction. In select patients, reconstructive urological surgery may become necessary. An individualized, patient-tailored approach is required for the management of lower urinary tract dysfunction in this special population

The Management of Lower Urinary Tract Dysfunction in Multiple Sclerosis

Purpose of Review Multiple sclerosis (MS) is the most frequent neuroinflammatory disease of the central nervous system and is commonly associated with lower urinary tract (LUT) dysfunction. As a consequence, health-related quality of life is often impaired and the upper urinary tract might be at risk for damage. The aim of this review is to give an overview of current treatment options for LUT dysfunction in patients with MS. Recent Findings The treatment is tailored to the type of dysfunction—storage or voiding dysfunction—beginning with conservative treatment options and ending with invasive therapies and surgery. Additionally, alternative options, e.g., different intravesical therapies or cannabinoids, have been evaluated in recent years with promising results. Summary Current available therapies offer different possible treatments for LUT dysfunction in patients with MS. They address either voiding or storage dysfunction and therefore ameliorate LUT symptoms improve quality of life and protect the upper urinary tract

Tibial Nerve Stimulation for the management of overactive bladder and the measurement of urinary neurotrophins as a biomarker of response to treatment

No abstract

Topics in Neuromodulation Treatment

"Topics in Neuromodulation Treatment" is a book that invites to the reader to make an update in this important and well-defined area involved in the Neuroscience world. The book pays attention in some aspects of the electrical therapy and also in the drug delivery management of several neurological illnesses including the classic ones like epilepsy, Parkinson's disease, pain, and other indications more recently incorporated to this important tool like bladder incontinency, heart ischemia and stroke. The manuscript is dedicated not only to the expert, but also to the scientist that begins in this amazing field. The authors are physicians of different specialties and they guarantee the clinical expertise to provide to the reader the best guide to treat the patient

Botulinum Toxin Treatment for Pain and Inflammation in Functional Urological Disorders

The botulinum toxin has been widely applied in the treatment of functional urological diseases, such as overactive bladder, neurogenic detrusor overactivity, interstitial cystitis, and chronic pelvic pain syndrome. Evidence has shown that the botulinum toxin not only affects the release of neuropeptides from motor nerve endings, but also connects sensory nerves to the central nervous system. Inflammation in the central nervous system can be reduced after botulinum toxin treatment. The scope of therapeutic targets involves detrusor overactivity, sensory disorders, bladder pain and pelvic pain, and inflammatory disorders of the bladder, prostate, and bladder outlet. Although the actual pathophysiological mechanism of the action of the botulinum toxin has not been completely demonstrated, an anti-inflammation effect might be the predominant therapeutic mechanism for functional urological disorders such as an overactive bladder, bladder hypersensitivity, interstitial cystitis, chronic pelvic pain syndrome, chronic prostatitis, and lower urinary tract symptoms/benign prostatic hyperplasia. This Special Issue of Toxins covers the therapeutic potentials of the botulinum toxin on lower urinary tract dysfunctions, with emphasis on the mechanism of pharmacological action and clinical effects

Neurogenic Bowel Dysfunction

Disorders of the central and peripheral nerve systems have severe effects on gut function. Hence, people who have sustained spinal cord injury and multiple sclerosis, Parkinson’s disease, or spina bifida patients may suffer from severe bowel symptoms, including constipation, incontinence to stools, difficult bowel evacuation, or pain. For the present book, a number of international experts have described how disorders of the nerve system affect bowel function, how to assess and treat bowel symptoms, and how the bacterial composition of the bowel may be affected

Fecal Incontinence

Fecal incontinence is a common and disabling condition that unfortunately remains an “orphan” in terms of medical research and effective therapies. This book provides a brief review of the pathophysiology of fecal incontinence with specific focus on women and children. Authorship is drawn internationally, with a strong surgical input. Contributions from the authors provide critical reviews of the evaluation of function, with illustrations of a range of surgical interventions which might be applied should medical therapies fail

Lower Urinary Tract Dysfunction

Lower urinary tract dysfunction (LUTD) is an umbrella diagnosis that covers the abnormalities of anatomy and function in the bladder, urethra, and, in men, the prostate. People with LUTD face a number of social, mental, and physical health effects due to the symptoms. Despite the increasing evidence in the assessment and management of lower urinary tract symptoms, it remains a challenge to bridge the gap between research evidence and clinical practice. In this book, each and every one of the authors presents a remarkable work for how to apply the evidence to clinical practice from different aspects. I hope this book is a key for every reader to open the door to LUTD