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Review
. 2022 Mar-Apr;48(2):220-243.
doi: 10.1590/S1677-5538.IBJU.2021.0098.

Neurogenic bladder - concepts and treatment recommendations

José Carlos Truzzi  1 , Fernando Gonçalves de Almeida  2 , Carlos Alberto Sacomani  3 , Joceara Reis  4 , Flávio Eduardo Trigo Rocha  5
Affiliations
Review

Neurogenic bladder - concepts and treatment recommendations

José Carlos Truzzi et al. Int Braz J Urol. 2022 Mar-Apr.

Abstract

Introduction: Bladder and urinary sphincter malfunctioning that results from some change in the central and/or peripheral nervous system is defined as neurogenic bladder. The urinary tract symptoms that can be related to its filling, emptying, or both have a significant impact on the quality of life of individuals. The present review was based on the document prepared for the public health system in Brazil as a treatment guidelines proposal.

Material and methods: Survey questions were structured as per PICO (Population, Intervention, Control, and Outcome). Search strategies were defined and performed in the MEDLINE/Pubmed, Embase, Epistemonikos and Google Scholar databases. The selection of articles followed the evidence hierarchy concept; evidence body was identified, and the quantitative study data were extracted. The quality of evidence and grade of recommendation were qualitatively assessed according to GRADE (Grading of Recommendations, Assessment, Development and Evaluations).

Results: A total of 2.707 articles were identified, with 49 of them being selected to compose the basis for this review. Neurogenic bladder treatments were classified according to their focus on filling or emptying symptoms and sub- classified in pharmacological and surgical treatments.

Conclusion: Treatment guidelines are important tools for the public health system to promote the best practice when treating neurogenic bladder patients.

Keywords: Therapeutics; Urinary Bladder, Neurogenic; Urinary Sphincter, Artificial.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1. Functional classification of neurogenic voiding disorders: combination of detrusor - sphincter dysfunction secondary to damage to the innervation of the lower urinary tract that provides the basis for the current therapeutic concepts.
Figure 2
Figure 2. Muscarinic and adrenergic receptors of the bladder
Figure 3
Figure 3. Botulinum toxin injection sites into bladder. (Image courtesy of Allergan, an AbbVie company)
Figure 4
Figure 4. A) Enterocystoplasty procedure: open bladder (appearance of an open scallop or clam) with the Foley catheter and detubulized ileum segment being anastomosed to the bladder; B) Cystouretrography before the enterocystoplasty: trabeculated bladder with multiple diverticulae; C) Cystouretrography after the enterocystoplasty.
See this image and copyright information in PMC

References

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