Stefania Musco1, Barbara Padilla-Fernández2, Giulio Del Popolo1, Matteo Bonifazi1, Bertil F M Blok3, Jan Groen3, Lisette 't Hoen3, Jürgen Pannek4, Jerome Bonzon4, Thomas M Kessler5, Marc P Schneider5, Tobias Gross6, Gilles Karsenty7, Véronique Phé8, Rizwan Hamid9, Hazel Ecclestone9, David Castro-Diaz2. 1. Department of Neuro-Urology, Careggi University Hospital, Florence, Italy. 2. Department of Urology, Hospital Universitario de Canarias, Universidad de La Laguna, Santa Cruz de Tenerife, Spain. 3. Department of Urology, Erasmus Medical Center, Rotterdam, The Netherlands. 4. Neuro-Urology, Swiss Paraplegic Center, Nottwil, Switzerland. 5. Neuro-Urology, Spinal Cord Injury Center & Research, University of Zürich, Balgrist University Hospital, Zürich, Switzerland. 6. Department of Urology, University of Bern, Inselspital, Bern, Switzerland. 7. Department of Urology, Aix Marseille University, Marseille, France. 8. Department of Urology, Pitié-Salpêtrière Academic Hospital, Paris 6 University, Paris Cedex 13, France. 9. Department of Neuro-Urology, London Spinal Injuries Centre, Stanmore, UK.
Abstract
AIM: The main goals of neurogenic lower urinary tract dysfunction (NLUTD) management are preventing upper urinary tract damage (UUTD), improving continence, and quality of life. Here, we aimed to systematically assess all available evidence on urodynamics predicting UUTD in patients with NLUTD. METHODS: A systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement was performed in March 2017. Only neuro-urological patients assessed by urodynamics were included. Any outcome of upper urinary tract function were evaluated. RESULTS: Forty-nine studies (1 randomized controlled trial, 9 prospective, and 39 retrospective case series) reported urodynamic data on 4930 neuro-urological patients. Of those, 2828 (98%) were spina bifida (SB) children. The total number of adults was 2044, mainly having spinal cord injury (SCI) (60%). A low bladder compliance was found in 568 (46.3%) and 341 (29.3%) of the paediatric and adult population, respectively. Hydronephrosis (HDN) was detected in 557 children (27.8%) in 19/28 studies and 178 adults (14.6%), mainly SCI, in 14/21 studies. Nine out of 30 multiple sclerosis (MS) patients affected by HDN (16.8%) showed low compliance in 4/14 studies. CONCLUSIONS: Patients with SB and SCI have a higher risk of developing UUTD (mainly reported as HDN) compared to those with MS. Reduced compliance and high DLPP were major risk factors for UUTD. Although our findings clarify the mandatory role of urodynamics in the management of NLUTD, standardization and better implementation of assessments in daily practice may further improve outcomes of neuro-urological patients based on objective measurements, that is, urodynamics.
AIM: The main goals of neurogenic lower urinary tract dysfunction (NLUTD) management are preventing upper urinary tract damage (UUTD), improving continence, and quality of life. Here, we aimed to systematically assess all available evidence on urodynamics predicting UUTD in patients with NLUTD. METHODS: A systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement was performed in March 2017. Only neuro-urological patients assessed by urodynamics were included. Any outcome of upper urinary tract function were evaluated. RESULTS: Forty-nine studies (1 randomized controlled trial, 9 prospective, and 39 retrospective case series) reported urodynamic data on 4930 neuro-urological patients. Of those, 2828 (98%) were spina bifida (SB) children. The total number of adults was 2044, mainly having spinal cord injury (SCI) (60%). A low bladder compliance was found in 568 (46.3%) and 341 (29.3%) of the paediatric and adult population, respectively. Hydronephrosis (HDN) was detected in 557 children (27.8%) in 19/28 studies and 178 adults (14.6%), mainly SCI, in 14/21 studies. Nine out of 30 multiple sclerosis (MS) patients affected by HDN (16.8%) showed low compliance in 4/14 studies. CONCLUSIONS:Patients with SB and SCI have a higher risk of developing UUTD (mainly reported as HDN) compared to those with MS. Reduced compliance and high DLPP were major risk factors for UUTD. Although our findings clarify the mandatory role of urodynamics in the management of NLUTD, standardization and better implementation of assessments in daily practice may further improve outcomes of neuro-urological patients based on objective measurements, that is, urodynamics.
Authors: James T Rague; Jeremy D Lai; Peggy Murphy; Andrea Fawcett; Ryan Walton; Ilina Rosoklija; Diana K Bowen; Elizabeth B Yerkes; Earl Y Cheng; Kavita S Hodgkins; Jonathan C Routh; Tamara Isakova; David I Chu Journal: J Urol Date: 2022-01-20 Impact factor: 7.600
Authors: David I Chu; Lauren C Balmert; Liqi Chen; Cameron Arkin; Theresa Meyer; Ilina Rosoklija; Diana K Bowen; Kavita S Hodgkins; Robin M Bowman; Earl Y Cheng; Elizabeth B Yerkes; Tamara Isakova Journal: J Urol Date: 2020-11-18 Impact factor: 7.450
Authors: Janina Beck; Anke Kirsten Jaekel; Federico Leopoldo Zeller; Michael Kowollik; Ines Kurze; Albert Kaufmann; Wolfgang Feneberg; Anna Brandt; Peter Flachenecker; Thomas Henze; Burkhard Domurath; Paul Schmidt; Will Nelson Vance; Franziska Goldschmidt; Ruth Klara Maria Kirschner-Hermanns; Stephanie C Knüpfer Journal: Diagnostics (Basel) Date: 2022-01-13