Neurogenic Bladder:: Assessment and Operative Management

Area of Science:

• Urology
• Neurology
• Reconstructive Surgery

Background:

• Neurogenic bladder (NGB) significantly impacts patients with neurological conditions like spinal cord injury (SCI), spina bifida (SB), cerebral palsy (CP), and multiple sclerosis (MS).
• Current management often requires tailored surgical interventions based on specific patient phenotypes.

Purpose of the Study:

• To present a phenotype-based surgical management strategy for neurogenic bladder (NGB).
• To categorize surgical options based on storage and emptying dysfunction.
• To highlight the importance of a holistic approach in surgical selection for NGB.

Main Methods:

• Describing prototypical patient phenotypes associated with SCI, SB, CP, and MS.
• Categorizing surgical management into failure to store and failure to empty.
• Reviewing mitigation strategies for common complications.

Main Results:

• Surgical options discussed include catheterizable channels, bladder augmentation, and bladder outlet procedures.
• Management strategies for complications are detailed.
• Emphasis is placed on considering social support, body habitus, and extremity function.

Conclusions:

• A phenotype-based, holistic approach is crucial for selecting appropriate surgical interventions for neurogenic bladder.
• Comprehensive management should address storage, emptying, and potential complications.
• Integrating patient-specific factors beyond bladder function is essential for optimal outcomes.