Consensus guidelines on the neurologist's role in the management of neurogenic lower urinary tract dysfunction in multiple sclerosis

Clin Neurol Neurosurg. 2013 Oct;115(10):2033-40. doi: 10.1016/j.clineuro.2013.06.018. Epub 2013 Jul 20.

Abstract

Objective: To review current management of neurogenic lower urinary tract dysfunction (NLUTD) in MS patients and give recommendations on the joint role of the neurologist and urologist in NLUTD management.

Methods: An algorithm for evaluation and referral of MS patients to urologists was created. It is an outcome of discussions about current knowledge, existing guidelines, and key issues during two Belgian consensus meetings attended by neurologists, urologists and other stakeholders involved in MS management. At these meetings, updated information on management of NLUTD in MS was exchanged and the neurologists' opinion on how to integrate this in the other aspects of care in MS patients was explored.

Results: Short evaluation of NLUTD in MS patients by neurologists and appropriate referral to urologists could accelerate proper diagnosis and treatment. Neurologists can play a central role in the inter-disciplinary communication on interactions between disease manifestations of MS and their treatments.

Conclusion: The coordinating role of neurologists in NLUTD management may considerably improve QoL in MS patients. More research is needed to evaluate outcomes of urological assessments and treatment.

Keywords: Multiple sclerosis; Neurogenic; Neurology; Urinary bladder; Urology.

MeSH terms

  • Botulinum Toxins, Type A / therapeutic use
  • Consensus
  • Gait Disorders, Neurologic / etiology
  • Guidelines as Topic
  • Humans
  • Lower Urinary Tract Symptoms / diagnosis
  • Lower Urinary Tract Symptoms / etiology
  • Lower Urinary Tract Symptoms / therapy*
  • Multiple Sclerosis / complications*
  • Neurology
  • Neuromuscular Agents
  • Physicians
  • Prevalence
  • Referral and Consultation
  • Risk Factors
  • Urinary Bladder / surgery
  • Urinary Bladder, Neurogenic / diagnosis
  • Urinary Bladder, Neurogenic / etiology
  • Urinary Bladder, Neurogenic / therapy*
  • Urologic Surgical Procedures
  • Urology

Substances

  • Neuromuscular Agents
  • Botulinum Toxins, Type A