Zusammenfassung
Neurogene Blasenfunktionsstörungen resultieren aus Erkrankungen oder Läsionen des zentralen oder peripheren Nervensystems, die die Innervation des unteren Harntrakts betreffen. Folgen sind charakteristische Veränderungen, die sich nach pathophysiologisch-urodynamischen Kriterien in Speicher- und Entleerungsstörungen unterscheiden lassen. Nicht immer ist bei neurogenen Veränderungen die Symptomatik des neurologischen Krankheitsbildes führend. Die Differenzialdiagnose der zugehörigen Blasenfunktionsstörung ist oftmals schwierig und erfordert genaue pathophysiologische Kenntnisse. Die Ätiologie reicht von kongenitalen, degenerativen, vaskulären, entzündlichen und immunologischen Prozessen bis hin zu tumorösen Veränderungen des Nervensystems. Vielfach ist zur genauen Differenzierung eine urodynamische Evaluation und eine frühzeitige interdisziplinäre Zusammenarbeit erforderlich, um besonders die Krankheiten diagnostizieren zu können, die eher selten zu initialen Blasensymptomen führen. Der in der Literatur geläufige Begriff der "nicht-neurogenen neurogenen Blase" oder des "Hinman-Syndroms" darf als urologische Diagnose so lange nicht gestellt werden, bis mögliche neurologische Ursachen durch moderne Diagnostik unter Verwendung neuester bildgebender Verfahren ausgeschlossen sind.
Abstract
Diseases or lesions of the central or peripheral nervous system involving the innervation of the lower urinary tract lead to neurogenic bladder dysfunction. Results are typical changes in storage and voiding function of the bladder according to pathophysiological and urodynamical criteria. In case of neurological disorders the neurological symptoms are not always the leading ones. The differential diagnosis of correlating bladder dysfunction is often difficult and special pathophysiological knowledge is necessary. Etiological factors are congenital, degenerative, vascular, inflammatory and immunological processes or tumour-specific changes of the nervous system. In many cases urodynamic evaluation and early interdisciplinary cooperation is necessary for special differentiation and diagnosis, especially of those diseases which rarely lead to initial bladder symptoms. The "nonneurogenic neurogenic bladder" or "Hinman-Syndrom" is well known in the literature but shouldn't be diagnosed until possible neurological reasons are excluded by modern diagnostic tools with newest imaging techniques.
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Schumacher, S., Haferkamp, A. & Müller, S.C. Blasendysfunktion bei seltenen neurologischen Erkrankungen. Urologe [A] 42, 1564–1568 (2003). https://doi.org/10.1007/s00120-003-0454-9
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DOI: https://doi.org/10.1007/s00120-003-0454-9