Urologic care of Neurologic conditions

Patients who suffer from neurologic problems such as Parkinson’s disease, spinal cord injury, stroke, and multiple sclerosis often also have significant urologic problems that are often undertreated.  These urinary problems can include incontinence, overactive bladder, urinary obstruction, or sexual dysfunction and can significantly decrease quality of life. If not properly treated these problems can become potentially life threatening by causing severe infections and kidney damage.  

Evaluation

In our experience, just recognizing that there are options for patients who have urologic problems from neurologic conditions is important.  Many patients are told, for example, that there are no better options than to leave a chronic Foley catheter in place permanently for their urinary symptoms.

Our evaluation starts with an understanding of the exact neurologic issue and how it might impact bladder function.  With certain levels of spinal cord injuries, for example, patient’s sphincters are not coordinated with bladder function and cause high pressure with urination and potentially put the kidneys at risk for permanent damage.

The evaluation may include includes tests such as videourodynamics to evaluate how well coordinated urination is and how it might have been affected. 

Treatment

Treatment is tailored to preventing any life-threatening complications and increasing quality of life for patients. Depending on severity of the problem, options include medications, intermittent urinary catheterization, augmenting the bladder capacity (augmentation cystoplasty) or potentially diverting the urine completely (urinary diversion).