The AUA/SUFU Guideline on Adult Neurogenic Lower Urinary Tract Dysfunction: Treatment and Follow-up

被引:75
作者
Ginsberg, David A. [1 ]
Boone, Timothy B. [2 ]
Cameron, Anne P. [3 ]
Gousse, Angelo [4 ]
Kaufman, Melissa R. [5 ]
Keays, Erick [6 ]
Kennelly, Michael J. [7 ]
Lemack, Gary E. [8 ]
Rovner, Eric S. [9 ]
Souter, Lesley H. [10 ]
Yang, Claire C. [11 ]
Kraus, Stephen R. [12 ]
机构
[1] Univ Southern Calif, Keck Sch Med, 1441 Eastlake Ave,Ste 7416, Los Angeles, CA 90089 USA
[2] Houston Methodist, Houston, TX USA
[3] Univ Michigan, Urol, Ann Arbor, MI 48109 USA
[4] Univ Miami, Mem Hosp Miramar, Coral Gables, FL 33124 USA
[5] Vanderbilt Urol Surg, Nashville, TN USA
[6] Patient Advocate, Los Angeles, CA USA
[7] Carolinas HealthCare Syst, Greenville, NC USA
[8] UT SouthWestern, Dallas, TX USA
[9] Med Univ South Carolina, Charleston, SC 29425 USA
[10] Nomad EBM Methodol, Seattle, WA USA
[11] Univ Washington, Seattle, WA 98195 USA
[12] UT Hlth San Antonio, San Antonio, TX USA
关键词
neurogenic bladder (or neurogenic lower urinary tract dysfunction); intermittent catheterization; indwelling catheter; botulinum toxin; anticholinergic; beta-3; agonist; urinary diversion; bladder augmentation; SPINAL-CORD-INJURY; LONG-TERM OUTCOMES; QUALITY-OF-LIFE; SACRAL NEUROMODULATION; DETRUSOR OVERACTIVITY; EXTERNAL SPHINCTEROTOMY; BLADDER MANAGEMENT; NECK CLOSURE; EFFICACY; AUGMENTATION;
D O I
10.1097/JU.0000000000002239
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Purpose: The clinician treating patients with neurogenic lower urinary tract dysfunction (NLUTD) needs to balance a variety of factors when making treatment decisions. In addition to the patient's urologic symptoms and urodynamic findings, other issues that may influence management options of the lower urinary tract include cognition, hand function, type of neurologic disease, mobility, bowel function/management, and social and caregiver support. This Guideline allows the clinician to understand the options available to treat patients, understand the findings that can be seen in NLUTD, and appreciate which options are best for each individual patient. This allows for decisions to be made with the patient, in a shared decision-making manner, such that the patient's quality of life can be optimized with respect to their bladder management. Materials and Methods: A comprehensive search for studies assessing patients undergoing evaluation, surveillance, management, or follow-up for NLUTD was conducted from January 2001 through October 2017 and was rerun in February 2021 to capture newer literature. The primary search returned 20,496 unique citations. Following a title and abstract screen, full texts were obtained for 3,036 studies. During full-text review, studies were primarily excluded for not meeting the PICO criteria. One hundred eight-four primary literature studies met the inclusion criteria and were included in the evidence base. Results: This guideline was developed to inform clinicians on the proper evaluation, diagnosis, and risk stratification of adult patients with NLUTD and the non-surgical and surgical treatment options available. Additional statements on urinary tract infection and autonomic dysreflexia were developed to guide the clinician. Conclusions: NLUTD patients may undergo non-surgical and surgical treatment options depending on their level of risk, symptoms, and urodynamic findings. Appropriate follow-up, primarily based on their risk stratification, must be maintained after treatment.
引用
收藏
页码:1106 / 1113
页数:8
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