Published 12 March 2009, doi:10.1136/bmj.b659
Cite this as: BMJ 2009;338:b659

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What is the most effective management of neurogenic bladder dysfunction?

Brian Buckley, Cochrane research fellow1, Adrian M Grant, professor of health services research2

1 Department of General Practice, National University of Ireland, Galway, 2 Institute of Applied Health Sciences, College of Life Sciences and Medicine, University of Aberdeen, Health Sciences Building, Aberdeen AB25 2ZD

Correspondence to: B Buckley bsbuckley@iol.ie

The first 150 words of the full text of this article appear below.

Neural damage from injury to the spinal cord or neurological conditions, such as multiple sclerosis or spina bifida, may cause neurogenic bladder dysfunction; this affects the ability to retain or to void urine, or both. Considerable uncertainty exists regarding the most effective management of neurogenic bladder dysfunction, which aims to prevent urinary tract infection and preserve upper urinary tract health, continence, and quality of life.1 2 The effect of incontinence on quality of life can hardly be overestimated.3

Management is usually long term, complex, and determined by the underlying neurological abnormality. It is often guided by urodynamic evaluation of lower urinary tract function. The patient’s preferences and availability of help from carers also affect management choices and must be carefully assessed.

Management options depend on the patient’s characteristics but include indwelling urethral or suprapubic catheterisation; intermittent catheterisation; urine collection by an external device; sacral nerve stimulation; and surgical techniques such as . . . [Full text of this article]


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