Abstract
Background
The scenario of the patient with neuropathies, which are related to urinary disorders, impacts the quality of life. Symptoms can lead to social isolation, impair activities of daily living, and shorten life expectancy. This study aims to make a practical and integrative review of current recommendations for the urogynecological approach of patients with neuropathy and urinary dysfunction.
Methods
The authors searched for data on combinations of the terms “lower urinary tract symptoms” AND “neurogenic voiding dysfunction” from January 2012 to January 2022 in the following scientific databases: PUBMED, MEDLINE, EMBASE, and The Cochrane Library. Inclusion criteria: randomized clinical trials, protocols from specialized societies and articles before that period, and according to clinical relevance. Exclusion criteria: case series or reports, expert opinions not endorsed by medical societies in the area.
Results
From the 25 studies mentioned, 09 studies were selected according to pre-established criteria and qualitative analysis of relevance. The authors add 2 references for relevance in the area of urogynecology and neurological diseases. According to the selected scientific references, the main neuropathies that can cause urinary dysfunction are CNS injuries such as stroke, spinal cord injury, meningomyelocele, and amyotrophic lateral sclerosis. Ten steps below were compiled to facilitate the gynecological approach, according to the researched literature.
Conclusion
It is important for the medical assistant to pay close attention to careful anamnesis and post-emptying urinary residual volume. The treatment in general addresses greater fluid intake, maneuvers to favor bladder emptying, medications, and/or intermittent self-catheterization. The approach of a multidisciplinary team can make a difference in the patient’s prognosis and quality of life.
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Data Availability
The authors declare that data supporting the findings of this study are available within the article. If necessary data will be shared with researchers for further analysis.
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JMMarra: project development, data collection, and writing/proofreading/editing of the manuscript.
PVCVieira: project development and proofreading/editing of the manuscript.
AMSMigueletto: project development, data collection, and proofreading/editing of the manuscript.
LFAOliveira: proofreading/editing of the manuscript.
ECarneiro: Data collection and proofreading/editing of the manuscript.
GV Marquini: project development and writing/proofreading/editing of the manuscript. The authors read and approved the final manuscript.
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The subjects in this trial have not concomitantly been involved in other studies. Data regarding any of the subjects in the study has not been previously published unless specified. Data will be made available to the editors of the journal for review or query upon request.
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Marra, J.M., de Castro Vieira, P.V., de Senna Migueletto, A.M. et al. Neurogenic Disorders and the Lower Urinary Tract Dysfunction: Proposed Approach for the Gynecologist. Reprod. Sci. 30, 2087–2091 (2023). https://doi.org/10.1007/s43032-023-01213-z
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DOI: https://doi.org/10.1007/s43032-023-01213-z