Abstract
One of the well reported but difficult to manage symptoms of spinal cord injury (SCI) is neurogenic lower urinary tract dysfunction (NLUTD). The type of NLUTD is variable based on location and extent of injury. SCI affects more males and NLUTD is especially debilitating for men with incomplete injury. This review summarizes the anatomical basis of NLUTD in SCI and discusses current diagnostic and management strategies that are being utilized clinically. The last two sections address new innovations and emerging discoveries with the goal of increasing scientific interest in improving treatment options for people with SCI. Areas warranting further investigation are pinpointed to address current gaps in knowledge and/or appropriate technology.
Highlights
Spinal cord injury (SCI) can affect sensory, motor, and autonomic tracts leading to neurogenic lower urinary tract dysfunction (NLUTD) [1]
Given that spinal control of micturition occurs at the S2–S4 elements of the sacral plexus, urinary manifestations of SCI can be broadly categorized as suprasacral, sacral, and infrasacral based on the level of the injury
SCI is unique from other NLUTD etiologies in that it is often accompanied by traumatic injuries and spinal shock syndrome
Summary
Spinal cord injury (SCI) can affect sensory, motor, and autonomic tracts leading to neurogenic lower urinary tract dysfunction (NLUTD) [1]. These people often are para and/or tetraplegics depending on injury location and men are more commonly affected. Men with SCI and NLUTD are at increased risk for infections, incontinence, vesicoureteral reflux, nephrolithiasis, and renal failure [3] These patients require multidisciplinary efforts for effective diagnosis and treatment [4]. Lower urinary tract dysfunction is characterized by simultaneous hyperactivity of both the detrusor muscle and external sphincter [7] This results in the bladder contracting against a closed sphincter. Understanding these differences is paramount to best practice as well as interpreting the efficacy of novel experimental treatments
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