Incontinence Due to Neurogenic Detrusor Overactivity

  • Jacques Corcos
  • Mikolaj Przydacz
Chapter

Abstract

  • Incontinence due to neurogenic detrusor overactivity (NDO) is often the most bothersome symptom that significantly decreases patients’ quality of life. It typically occurs when neurological lesions affect suprapontine and/or suprasacral pathways regulating functions of the bladder. This mainly includes patients after stroke or suprasacral spinal cord injury as well as those with multiple sclerosis and Parkinson disease.

  • Comprehensive history and physical examination need to be supported by a bladder diary, symptom questionnaires, urinalysis, urine culture, pad-weighing test, renal assessment, and other investigations. Urodynamic study is the cornerstone in the diagnosis and management of patients suffering from incontinence due to NDO. Investigated abnormalities include involuntary detrusor contractions, decreased compliance, increased bladder sensation, and/or decreased cystometric capacity.

  • Treatment of NDO aims to protect renal function and improve quality of life. Management includes conservative treatment, pharmacotherapy, bladder injections with botulinum toxin A, nerve stimulation, and surgery.

Keywords

Incontinence Neurogenic detrusor overactivity Stroke Spinal cord injury Multiple sclerosis Parkinson disease Medical history Physical examination Questionnaires Bladder diary Urinalysis Urine culture Detrusor overactivity Decreased compliance Increased bladder sensation Decreased cystometric capacity Anticholinergics Antimuscarinics Botulinum toxin A Neuromodulation Neurostimulation Tibial nerve stimulation Bladder augmentation Enterocystoplasty Auto-augmentation 

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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Jacques Corcos
    • 1
  • Mikolaj Przydacz
    • 1
  1. 1.Department of UrologyJewish General Hospital, McGill UniversityMontrealCanada

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