Clinical Guidelines of Patient-Centered Bladder Management of Neurogenic Lower Urinary Tract Dysfunction Due to Chronic Spinal Cord Injury – Part 3: Surgical Treatment in Chronic Spinal Cord Injured Patients
Year: 2023
Type: article
Abstract: This article reports the current evidence and expert opinions on patient-centered bladder management of neurogenic lower urinary tract dysfunction (NLUTD) among chronic spinal cord injured (SCI) patients in Taiwan. The main problems with SCI-NLUTD are failure to store, empty, or both. The management of SCI-NLUTD should be prioritized as follows: (a) preservation of renal function, (b) freedom from urinary tract infection, (c) efficient bladder emptying, (d) freedom from indwelling catheters, (e) patient agreement with management, and (f) avoidance of medication after proper management. The management of NLUTD in SCI patients must be based on urodynamic findings rather than neurologic evaluation inferences. It is important to identify high-risk patients to prevent renal functional deterioration in those with chronic SCI-NLUTD. Urodynamic studies should be performed on patients with SCI on a regular basis, and any urological complications should be adequately treated. When surgery is required, less invasive and reversible procedures should be considered first, and any unnecessary surgery in the lower urinary tract should be avoided. The most important aspect of treatment is to improve the quality of life in SCI patients with NLUTD. Annual active surveillance of bladder and renal function is required to avoid renal function deterioration and urological complications, particularly in high-risk SCI patients.
Source: Urological Science
Institutions: Fu Jen Catholic University, Cardinal Tien Hospital, National Yang Ming Chiao Tung University, Taipei Veterans General Hospital, Chang Gung University, Chang Gung Memorial Hospital, Keelung Chang Gung Memorial Hospital, Kaohsiung Chang Gung Memorial Hospital, Taichung Veterans General Hospital, National Taiwan University Hospital, National Taiwan University, Taoyuan Chang Gung Memorial Hospital, Linkou Chang Gung Memorial Hospital, Kaohsiung Medical University, Kaohsiung Medical University Chung-Ho Memorial Hospital, E-Da Hospital, I-Shou University, Ministry of Health and Welfare, Taipei Hospital, Chung Yuan Christian University, En Chu Kong Hospital, Tzu Chi University, Tzu Chi Foundation, Hualien Tzu Chi Medical Center
Language: English
Subfield: Urology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4380991973