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Surveillance Urodynamics for Neurogenic Lower Urinary Tract Dysfunction: A Systematic Review

Overview
Specialty Urology
Date 2018 Dec 12
PMID 30526805
Citations 4
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Abstract

Introduction: Baseline urodynamic characterization in patients with neurogenic lower urinary tract dysfunction (NLUTD) allows detection of unsafe storage and voiding pressures and optimization of these parameters through medical or surgical intervention. Surveillance urodynamics (sUDS) studies are performed in the ambulatory setting after baseline characterization, with the goal of monitoring bladder function. How often this study should be performed and the circumstances that should prompt repeated studies are unknown. The primary objective of this review is to evaluate the evidence supporting sUDS in the setting of NLUTD as assessed by whether the study leads to 1) change in patient management; 2) determination of new findings not suggested by imaging or symptoms; and 3) demonstration of superior outcomes compared to observation. The secondary objective is to review sUDS practice patterns among urologists in their assessment of NLUTD.

Methods: PubMed, EMBASE, and Cochrane Library databases were reviewed for English-language literature published between January 1975 and March 2018.

Results: Twenty-eight independent articles (1368 patients, 9486 patient-years of followup) were included. Given heterogeneous data, 49% of 263 subjects were asymptomatic, yet demonstrated sUDS abnormality prompting treatment. Eight cross-sectional studies (four spinal cord injury [SCI], two NLUTD, two spina bifida) surveyed urologists regarding current sUDS patterns; 53% of 498 respondents perform sUDS between one and three years.

Conclusions: Evidence supporting optimal surveillance for NLUTD is lacking. Level 2b-4 evidence suggests that sUDS is likely to modify patient treatment and often demonstrates findings that modify treatment in the absence of symptoms or imaging changes.

Citing Articles

2023 Canadian Urological Association/Pediatric Urologists of Canada guideline: Pediatric patients with neurogenic lower urinary tract dysfunction Full-text version.

Chua M, Yadav P, Wang P, Mau E, Keefe D, De Los Reyes T Can Urol Assoc J. 2023; 17(10):E338-E357.

PMID: 37851907 PMC: 10581733. DOI: 10.5489/cuaj.8390.


A prospective assessment of the validity of the CUA neurogenic bladder guideline.

Abed H, Hassouna M, Aldossary N, Mckibbon M, Welk B Can Urol Assoc J. 2023; .

PMID: 37787593 PMC: 10697712. DOI: 10.5489/cuaj.8439.


Prevalence of Unfavorable Video-Urodynamic Findings and Clinical Implications in Patients with Minimally Conscious State/Unresponsive Wakefulness Syndrome: A Retrospective Descriptive Analysis.

Leboutte F, Engesser C, Zahiti L, Rentsch C, Seifert H, Anding R Biomedicines. 2023; 11(9).

PMID: 37760873 PMC: 10525630. DOI: 10.3390/biomedicines11092432.


Conservative Bladder Management and Medical Treatment in Chronic Spinal Cord Injury Patients.

Ong H, Chiang I, Hsu L, Chin C, Shao I, Jang M J Clin Med. 2023; 12(5).

PMID: 36902808 PMC: 10003947. DOI: 10.3390/jcm12052021.

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