Evaluation and Management of Neurogenic Stress Urinary Incontinence

Abstract

Neurogenic bladder is a broad term that encompasses many different types of neurologic diseases and a wide spectrum of dysfunction of the lower urinary tract. Patient with neurogenic stress urinary incontinence (SUI) have poor urine store storage due to outlet dysfunction. Office examination, cystoscopy, video urodynamics (UDS), and renal imaging all play an important role in evaluating these patients (Wyndaele et al. Neurourol Urodyn. 2009;29:662-669 [27]). Based on patients’ overall function, bladder capacity and compliance, and ability to void or perform clean intermittent catheterizations, outlet procedures such as slings and artificial urinary sphincters may be offered safely (Arun Sahai et al. Curr Urol Rep. 2011;12:404-412 [28••]). Other options for partial or complete urinary diversion exist for patients with limited residual function or low capacity bladders. Improving continence in this population can positively impact quality of life and help with issues such as skin break down and chronic infection from incontinence (Ku. BJU Int. 2006;98:739-745 [26]).