Lower urinary tract dysfunction in patients with peripheral nervous system lesions.

Area of Science:

• Neurology
• Urology
• Neuroscience

Background:

• Peripheral nervous system (PNS) disorders are associated with a higher prevalence of lower urinary tract (LUT) dysfunction compared to general populations.
• Autonomic nervous system involvement in polyneuropathies and localized lesions affecting LUT innervation are key contributors.
• LUT symptoms can be critical indicators for diagnosing spinal canal (e.g., cauda equina syndrome) and pelvic pathologies.

Purpose of the Study:

• To highlight the significant link between PNS disorders and LUT dysfunction.
• To discuss the diagnostic implications and management strategies for neurogenic LUTD.
• To emphasize the impact of LUTD on patient quality of life and potential complications.

Main Methods:

• Review of clinical presentations and diagnostic approaches for LUTD in PNS disorders.
• Discussion of neurophysiologic testing for diagnosing chronic neurogenic LUTD.
• Consideration of surgical interventions and their impact on LUT function.

Main Results:

• PNS involvement commonly leads to hypoactive bladder and sphincter function, resulting in poor emptying and incontinence.
• Bladder overactivity can paradoxically occur in some PNS lesions.
• Acute cauda equina syndrome necessitates emergency intervention, while chronic cases benefit from neurophysiologic assessment.

Conclusions:

• Neurogenic lower urinary tract dysfunction is a common and significant complication of peripheral nervous system disorders.
• Prompt diagnosis, including neurophysiologic testing and urodynamics when necessary, is essential for effective management.
• Preventive surgical techniques and thorough patient assessment are vital to mitigate the impact on quality of life and prevent secondary infections.