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Related Concept Videos

The Micturition Reflex01:26

The Micturition Reflex

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Urination, or micturition involves the coordination of the bladder's detrusor muscle and two sphincters to ensure controlled bladder emptying.
The process begins with bladder filling, where the bladder wall stretches as urine accumulates. This stretching activates the urine storage reflex, mediated by the sacral spinal segments and the pontine storage center. Efferent sympathetic impulses stimulate the detrusor muscle to relax and the internal urethral sphincter to contract, facilitating...
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Disorders of the Urinary System01:20

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The urinary system is responsible for eliminating waste and excess fluids from the body. However, disorders of the urinary system can arise due to various reasons like infections, stress, age, congenital abnormalities, and lifestyle.
Urinary tract infections (UTIs) are one of the most common urinary system disorders. They are caused by bacteria that enter the urethra and can spread to the bladder resulting in cystitis. Pyelonephritis is the result of a UTI that has ascended to the level of the...
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Related Experiment Video

Updated: May 23, 2025

Ultrasonography of the Adult Male Urinary Tract for Urinary Functional Testing
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Can We Improve Our Routine Urological Assessment to Exclude Neurogenic Causes for Lower Urinary Tract Dysfunction?

Marcus J Drake1,2, Salvador Arlandis3, Marcio A Averbeck4

  • 1Department of Surgery and Cancer, Imperial College, London, UK.

Neurourology and Urodynamics
|March 10, 2025
PubMed
Summary

Early diagnosis of neurological conditions causing urinary symptoms is crucial. A thorough neuro-urological examination can help identify occult neurological disease, improving patient prognosis and outcomes.

Keywords:
LUTSSpina bifidaautonomicneuro‐urologyurodynamics

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Area of Science:

  • Neurology
  • Urology
  • Neuroscience

Background:

  • Urinary symptoms can sometimes indicate an underlying neurological condition that may not be immediately apparent.
  • Increased clinical awareness can lead to earlier diagnosis and improved patient outcomes.

Purpose of the Study:

  • To consider the clinical pathway for identifying undiagnosed neurological or autonomic contributions to urinary symptoms.
  • To evaluate the implications of these diagnoses for patient prognosis.

Main Methods:

  • A 2024 think-tank by the International Consultation on Incontinence Research Society reviewed the identification pathway for neurological causes of urinary symptoms.
  • Consideration of associated bowel and sexual dysfunction was emphasized.
  • Assessment of sacral reflexes and pelvic sensations was discussed as potential indicators of neurological mechanisms.

Main Results:

  • Missed diagnoses can include adult-onset, congenital, and pediatric-acquired neurogenic conditions, potentially exacerbated by growth spurts.
  • Current screening tools are limited, being single-system or population-specific.
  • The sensitivity and specificity of neuro-urological examinations are currently unknown, but incorporating neuro-perineal findings may aid interpretation.

Conclusions:

  • Future research should investigate the diagnostic value of neuro-urological examinations for occult neurological diseases.
  • Development of screening tools or risk scores for occult neurology based on pelvic organ symptoms is recommended.
  • The appropriateness of non-neurologist practitioners ordering neurological investigations like MRI needs further consideration.