[Benign prostatic hyperplasia and neurourology]

Benign prostatic hyperplasia, which is usually treated conservatively (except in the presence of complications) in non-neurological patients, needs to be managed even more cautiously in patients with neurogenic bladder. The treatment decision must include analysis of the previous voiding mode. The development of detrusor-sphincter dyssynergia in an elderly man with a neurological disease must raise the suspicion of prostatic obstruction. The difficulty of establishing a diagnosis of obstruction, that cannot always be confirmed by clinical tools, urodynamic assessment or the search for renal complications, may lead to temporary prostatic stenting as a diagnostic procedure. Certain situations are more specifically encountered in patients with neurogenic bladder: spinal cord injury patients with reflex voiding, patients with stroke and its sequelae, ageing men and diabetic patients.