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Area of Science:

  • Neurourology
  • Urology
  • Nephrology

Background:

  • Neurogenic bladder significantly impacts quality of life and can lead to severe complications like febrile urinary tract infections (UTIs) and renal impairment.
  • Effective management requires understanding and prioritizing risk factors and associated complications.

Purpose of the Study:

  • To specify and rank neurogenic bladder risk factors, their consequences, and induced complications within neurourology.
  • To provide clinical elements for assessing and monitoring patients with neurogenic bladder.

Main Methods:

  • A Delphi consensus study was conducted involving a multidisciplinary expert panel.
  • A comprehensive literature review informed initial proposals, followed by three rounds of expert evaluation and rating.

Main Results:

  • Twenty-two expert-validated proposals were established, with six addressing complications (renal failure, febrile UTIs, autonomic dysreflexia) and 16 focusing on risk factors.
  • Identified risk factors include disease modality (e.g., spinal cord injury), urodynamic characteristics (e.g., detrusor leak point pressure ≥40 cmH2O, low bladder compliance), and treatment-related factors (e.g., catheter use).
  • The study highlighted a lack of validated criteria and the need for evidence-based risk stratification.

Conclusions:

  • This consensus provides a framework for understanding and prioritizing neurogenic bladder complications and risk factors.
  • The findings can aid practitioners in distinguishing high-risk patients, improving management, and potentially preventing complications such as renal failure and UTIs.