Highlights on the latest developments in neurourology - diagnostic technology

Improved appreciation of detrusor malfunction within the complex pathology of lower urinary tract syndrome has led to increased interest in detrusor muscle disorders and possible detrusor myopathies. The rapid development of alternative methods and new pharmacological agents for the treatment of lower urinary tract dysfunction initiate subtle differential diagnosis of the underlying pathology. Research activities related to bladder physiology, neurophysiology and neuropharmacology have increased in the last 10 years. Primarily a purely basic scientific field, neurourology now commences to become a clinically highly significant and useful research domain. This article offers insight into the latest developments in the diagnostic techniques of this exciting field. One of these is smooth muscle EMG of the urinary bladder that aims at distinguishing between signal pattern changes and subsequent evaluation of the different functional and electrophysiological states of smooth muscle cells in various pathologies or in pharmacological tests during urodynamic investigation. A second innovative method in geriatric patients is the measurement of the sensory input to the brain due to bladder distention. The reported techniques are two new examples of lower urinary tract evaluation that contribute to knowledge on the physiology and pathophysiology of the urinary bladder.