Treatment of Neurogenic Bladder with Stress Urinary Incontinence
Stress urinary incontinence (SUI) is a recognised and clinically significant manifestation of neurogenic lower urinary tract dysfunction (NLUTD). Managing it requires careful patient selection and a clear understanding of where conservative options reach their limits.
Clinical Situation
This protocol addresses patients with neurogenic bladder who present with stress urinary incontinence. In this population, involuntary urine loss occurs as a consequence of neurologically impaired urethral and bladder outlet control. Less invasive interventions such as urethral bulking agents may be offered, but clinicians must counsel patients that efficacy is modest and cure is uncommon.
Intervention Approach
For carefully selected patients with NLUTD and refractory stress urinary incontinence, a definitive surgical approach targeting bladder outlet control — paired with an appropriate bladder drainage strategy — may be considered following thorough shared decision-making.
Full protocol detail, patient selection criteria, and procedural considerations are available below.
References
- Clinicians may offer urethral bulking agents to NLUTD patients with stress urinary incontinence but must counsel them that efficacy is modest and cure is rare.
- After a thorough discussion of risks, benefits, and alternatives, clinicians may offer bladder neck closure and concomitant bladder drainage methods to select patients with NLUTD and refractory stress urinary incontinence.
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