Lower urinary tract (LUT) dysfunction is a commonly reported sequelae of neuroinflammatory
disorders such as Multiple sclerosis, NMO spectrum disorders and MOG associated transverse
myelitis, and have a significant impact on quality of life. The pattern of LUT dysfunction
is influenced by the site of neurological lesion and patients may present with storage
and/or voiding dysfunction. The risk for developing upper urinary tract damage is
considerably lower, compared to other disorders such as spinal cord injury or spina
bifida. History taking forms the cornerstone of assessment, and urinalysis, ultrasonography
and urodynamics provide information about the cause and nature of LUT dysfunction.
Antimuscarinic agents are the first line management of urinary incontinence, however
the side effect profile and anticholinergic burden should be considered when prescribing
these medications. Beta-3 receptor agonists are a promising alternative oral medication.
Tibial and sacral neuromodulation have been shown to be effective for managing neurogenic
incontinence. Intradetrusor injections of onabotulinumtoxinA have revolutionised the
management of neurogenic detrusor overactivity. Patients with neuroinflammatory disorders
reporting LUT symptoms require a comprehensive evaluation for planning a patient-tailored
approach to management.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of the Neurological SciencesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
