R Böthig1, B Domurath2, A Kaufmann3, J Bremer4, W Vance2, I Kurze5. 1. Abt. Neuro-Urologie, Querschnittgelähmtenzentrum, BG-Klinikum Hamburg, Bergedorfer Str. 10, 21033, Hamburg, Deutschland. r.boethig@bgk-hamburg.de. 2. Neurologische Rehabilitationsklinik, Neuro-Urologisches Zentrum, Kliniken Beelitz GmbH, Paracelsusring 6a, 14547, Beelitz-Heilstätten, Deutschland. 3. Zentrum für Kontinenz und Neuro-Urologie, Kliniken Maria Hilf GmbH, Viersener Str. 450, 41063, Mönchengladbach, Deutschland. 4. Zentrum für Neuro-Rehabilitation, Querschnittgelähmten-Zentrum, BDH-Klinik Greifswald gGmbH, Karl-Liebknecht-Ring 26a, 17491, Greifswald, Deutschland. 5. Querschnittgelähmten-Zentrum, Klinik für Paraplegiologie und Neuro-Urologie, Zentralklinik Bad Berka, Robert-Koch-Allee 9, 99437, Bad Berka, Deutschland.
Abstract
BACKGROUND: Most patients with spinal cord injury (SCI) suffer from neurogenic lower urinary tract dysfunction (NLUTD), bowel dysfunction and sexual dysfunction. If these remain untreated, severe medical complications and serious limitations (restrictions) in quality of life are imminent. OBJECTIVES: In the long term, there are considerable differences in the treatment results of highly specialized centers versus other treatment facilities. MATERIALS AND METHODS: Against this background, a consensus-based guideline, according to the AWMF (Association of the Scientific Medical Societies in Germany) criteria (S2k), was developed by the neuro-urology working group of the DMPG (German-Speaking Medical Society of Paraplegia). RESULTS: The guideline defines the principles and objectives of the neuro-urological care of patients with SCI and discusses in detail the principles of diagnosis and therapy of NLUTD. The need for video-urodynamic studies as a basis for the classification of the NLUTD and as a foundation for the development of a treatment strategy is emphasized. Both conservative and surgical therapy options and their indications are explained in detail. Possible complications and their prevention in the long-term course of SCI are presented with a particular consideration of the specific features of urinary tract infections and autonomic dysreflexia. Finally, the principles of the provision of urological appliances are discussed. CONCLUSIONS: The presented S2k guideline provides the current standards in the neuro-urological care of patients with NLUTD due to SCI. Their consistent implementation both in the acute and chronic phase as well as in the context of lifelong surveillance of SCI patients should prevent the impending complications of NLUTD.
BACKGROUND: Most patients with spinal cord injury (SCI) suffer from neurogenic lower urinary tract dysfunction (NLUTD), bowel dysfunction and sexual dysfunction. If these remain untreated, severe medical complications and serious limitations (restrictions) in quality of life are imminent. OBJECTIVES: In the long term, there are considerable differences in the treatment results of highly specialized centers versus other treatment facilities. MATERIALS AND METHODS: Against this background, a consensus-based guideline, according to the AWMF (Association of the Scientific Medical Societies in Germany) criteria (S2k), was developed by the neuro-urology working group of the DMPG (German-Speaking Medical Society of Paraplegia). RESULTS: The guideline defines the principles and objectives of the neuro-urological care of patients with SCI and discusses in detail the principles of diagnosis and therapy of NLUTD. The need for video-urodynamic studies as a basis for the classification of the NLUTD and as a foundation for the development of a treatment strategy is emphasized. Both conservative and surgical therapy options and their indications are explained in detail. Possible complications and their prevention in the long-term course of SCI are presented with a particular consideration of the specific features of urinary tract infections and autonomic dysreflexia. Finally, the principles of the provision of urological appliances are discussed. CONCLUSIONS: The presented S2k guideline provides the current standards in the neuro-urological care of patients with NLUTD due to SCI. Their consistent implementation both in the acute and chronic phase as well as in the context of lifelong surveillance of SCI patients should prevent the impending complications of NLUTD.
Entities:
Keywords:
AWMF guideline; Autonomic dysreflexia; Neurogenic lower urinary tract dysfunction due to spinal cord injury; Urinary incontinence; Urinary tract infection
Authors: Suzanne L Groah; David A Weitzenkamp; Daniel P Lammertse; Gale G Whiteneck; Dennis C Lezotte; Richard F Hamman Journal: Arch Phys Med Rehabil Date: 2002-03 Impact factor: 3.966
Authors: T Wang; K X Xu; W Y Zhang; H Hu; X W Zhang; H R Wang; X H Liu; J W Chen; X P Zhang Journal: Beijing Da Xue Xue Bao Yi Xue Ban Date: 2019-12-18
Authors: Ralf Böthig; Burkhard Domurath; Johannes Kutzenberger; Jörn Bremer; Ines Kurze; Albert Kaufmann; Jana Pretzer; Jens-Peter Klask; Birgitt Kowald; Christian Tiburtius; Klaus Golka; Sven Hirschfeld; Roland Thietje Journal: J Multidiscip Healthc Date: 2020-02-27
Authors: Christopher Ull; Emre Yilmaz; Oliver Jansen; Sebastian Lotzien; Thomas A Schildhauer; Mirko Aach; Matthias Königshausen Journal: Global Spine J Date: 2020-09-10