Characteristics of neurogenic lower urinary tract dysfunction patients at Cipto Mangunkusumo Hospital

  • Fina Widia Department of Urology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Madhyra Tri Indraswari Department of Urology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia https://orcid.org/0000-0001-8670-9771
  • Harrina Erlianti Rahardjo Department of Urology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia https://orcid.org/0000-0003-4458-4055
Keywords: nervous system diseases, population characteristics, urinary incontinence, urinary tract infection
Abstract viewed: 247 times
PDF downloaded: 206 times
HTML downloaded: 82 times
EPUB downloaded: 76 times

Abstract

BACKGROUND Neurogenic lower urinary tract dysfunction (NLUTD) is an abnormal function of the bladder, urethra (and/or prostate in males) in patients with a clinically confirmed relevant neurologic disorder. Hence, accurate diagnosis and management of NLUTD is crucial. This study aimed to recognize the characteristics of NLUTD to identify, manage, and prevent the associated complications.

METHODS This retrospective study was conducted at the Outpatient Clinic of the Department of Urology, Cipto Mangunkusumo Hospital, Jakarta, Indonesia, from January 2011 to December 2021. The study analyzed data collected from voiding dysfunction patients with upper motor neurological disorders who underwent urodynamic studies during the study period. Incomplete data in the medical records were excluded.

RESULTS Mean age of the participants was 50.7 (18–95) years old. The most common cause of NLUTD was stroke (26.6%), followed by unspecified groups and spinal cord injury. Patients under 20 years old were affected by trauma and congenital defects. Of the patients, 34.0% had urinary retention, and 18.1% had incontinence. Small bladder capacity occurred in patients with stroke, Parkinson’s disease, and spinal/cerebral tumors, leading to decreased bladder compliance.

CONCLUSIONS NLUTD was associated with aging, with upper motor neurological lesions such as trauma, stroke, and spinal/cerebral injury being the most common etiologies. Most patients with NLUTD had small bladder capacity and decreased compliance based on urodynamic result.

Downloads

Download data is not yet available.

References

  1. Gajewski JB, Schurch B, Hamid R, Averbeck M, Sakakibara R, Agrò EF, et al. An International Continence Society (ICS) report on the terminology for adult neurogenic lower urinary tract dysfunction (ANLUTD). Neurourol Urodyn. 2018;37(3):1152-61. https://doi.org/10.1002/nau.23397

  2. Leslie SW, Tadi P, Tayyeb M. Neurogenic bladder and neurogenic lower urinary tract dysfunction. [Updated 2022 Nov 28]. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2023.

  3. Neurogenic Bladder Turkish Research Group; Yıldız N, Akkoç Y, Erhan B, Gündüz B, Yılmaz B, et al. Neurogenic bladder in patients with traumatic spinal cord injury: treatment and follow-up. Spinal Cord. 2014;52(6):462-7. https://doi.org/10.1038/sc.2014.41

  4. Soedarman S, Rahardjo HE. Potential predictors of detrusor underactivity in a urology outpatient clinic: a 5-year single center experience study. Med J Indones. 2021;30(3):207-10. https://doi.org/10.13181/mji.oa.215102

  5. Yao M, Simoes A. Urodynamic testing and interpretation. In: StatPearls. Treasure Island: StatPearls Publishing; 2022 Jan-.

  6. Jeong SJ, Kim HJ, Lee YJ, Lee JK, Lee BK, Choo YM, et al. Prevalence and clinical features of detrusor underactivity among elderly with lower urinary tract symptoms: a comparison between men and women. Korean J Urol. 2012;53(5):342-8. https://doi.org/10.4111/kju.2012.53.5.342

  7. Dorsher PT, McIntosh PM. Neurogenic bladder. Adv Urol. 2012;2012:816274. https://doi.org/10.1155/2012/816274

  8. Hamid R, Averbeck MA, Chiang H, Garcia A, Al Mousa RT, Oh SJ, et al. Epidemiology and pathophysiology of neurogenic bladder after spinal cord injury. World J Urol. 2018;36(10):1517-27. https://doi.org/10.1007/s00345-018-2301-z

  9. Blok B, Castro-Diaz D, Popolo GD, Groen J, Hamid R, Karsenty TM, et al. EAU guidelines on neuro-urology. European Association of Urology (EAU);2020.

  10. Lee HS, Choi JG, Shin JH. Urological disturbance and its neuroanatomical correlate in patients with chronic brainstem stroke. Neurourol Urodyn. 2017;36(1):136-41. https://doi.org/10.1002/nau.22889

  11. Burney TL, Senapati M, Desai S, Choudhary ST, Badlani GH. Acute cerebrovascular accident and lower urinary tract dysfunction: a prospective correlation of the site of brain injury with urodynamic findings. J Urol. 1996;156(5):1748-50. https://doi.org/10.1016/S0022-5347(01)65498-3

  12. Kulaklı F, Koklu K, Ersoz M, Ozel S. Relationship between urinary dysfunction and clinical factors in patients with traumatic brain injury. Brain Inj. 2014;28(3):323-7. https://doi.org/10.3109/02699052.2013.865268

  13. Agrawal M, Joshi M. Urodynamic patterns after traumatic spinal cord injury. J Spinal Cord Med. 2015;38(2):128-33. https://doi.org/10.1179/2045772313Y.0000000136

  14. Kadow BT, Tyagi P, Chermansky CJ. Neurogenic causes of detrusor underactivity. Curr Bladder Dysfunct Rep. 2015;10(4):325-31. https://doi.org/10.1007/s11884-015-0331-6

  15. Sawin KJ, Liu T, Ward E, Thibadeau J, Schechter MS, Soe MM, et al. The National Spina Bifida Patient Registry: profile of a large cohort of participants from the first 10 clinics. J Pediatr. 2015;166(2):444-50.e1. https://doi.org/10.1016/j.jpeds.2014.09.039

  16. De Cicco FL, Camino Willhuber GO. Nucleus pulposus herniation. [Updated 2021 Aug 11]. In: StatPearls. Treasure Island: StatPearls Publishing; 2022 Jan-.

  17. Bartolin Z, Savic I, Persec Z. Relationship between clinical data and urodynamic findings in patients with lumbar intervertebral disk protrusion. Urol Res. 2002;30(4):219-22. https://doi.org/10.1007/s00240-002-0264-3

  18. Siracusa G, Sparacino A, Lentini VL. Neurogenic bladder and disc disease: a brief review. Curr Med Res Opin. 2013;29(8):1025-31. https://doi.org/10.1185/03007995.2013.807788

  19. Shrivastava N, Singh P, Nayak B, Garg B. The spectrum of clinical and urodynamic findings in patients with spinal tuberculosis exhibiting lower urinary tract symptoms, before and after spinal surgical intervention with antitubercular treatment: a prospective study. Asian Spine J. 2019;13(4):615-20. https://doi.org/10.31616/asj.2018.0217

  20. Majima T, Matsukawa Y, Funahashi Y, Takai S, Kato M, Yamamoto T, et al. Urodynamic analysis of the impact of diabetes mellitus on bladder function. Int J Urol. 2019;26(6):618-22. https://doi.org/10.1111/iju.13935

  21. Hidayat B, Ramadani RV, Rudijanto A, Soewondo P, Suastika K, Siu Ng JY. Direct medical cost of type 2 diabetes mellitus and its associated complications in Indonesia. Value Health Reg Issues. 2022;28:82-9. https://doi.org/10.1016/j.vhri.2021.04.006

  22. Yuan Z, Tang Z, He C, Tang W. Diabetic cystopathy: a review. J Diabetes. 2015;7(4):442-7. Erratum in: J Diabetes. 2016;8(1):170. https://doi.org/10.1111/1753-0407.12272

  23. Kaplan SA, Te AE, Blaivas JG, McGuire EJ. Urodynamic findings in patients with Diabetic cystopathy. J Urol. 1995;153(2):342-4. https://doi.org/10.1016/S0022-5347(17)52088-1

  24. Calabrò RS. Sexual dysfunction in neurological disorders: do we see just the tip of the iceberg? Acta Biomed. 2018;89(2):274-5.

  25. Martinez L, Neshatian L, Khavari R. Neurogenic bowel dysfunction in patients with neurogenic bladder. Curr Bladder Dysfunct Rep. 2016;11(4):334-40. https://doi.org/10.1007/s11884-016-0390-3

Published
2023-06-15
How to Cite
1.
Widia F, Indraswari MT, Rahardjo HE. Characteristics of neurogenic lower urinary tract dysfunction patients at Cipto Mangunkusumo Hospital. Med J Indones [Internet]. 2023Jun.15 [cited 2024Jun.24];32(1):31-7. Available from: http://mji.ui.ac.id/journal/index.php/mji/article/view/6605
Section
Clinical Research