BLADDER DYSFUNCTION IN DISSEMINATED ENCEP HALOMYELITIS - DRUG-THERAPYAND INTERVENTIONAL METHODS

Patients with disseminated encephalomyelitis have Various urological p resentations, ranging from pollakisuria to urge incontinence. After de tailed evaluation (neuro-urological examination, urodynamic investigat ion) drug therapy and various interventional methods must be adapted t o the individual manifestations. Patients with detrusor hyperreflexia are treated with oral anticholinergic agents (oxybutynin, trospium chl oride, propiverine). Patients with urinary retention are recommended t o be managed with clean intermittent (self)-catheterisation. The vario us interventional therapeutic options (bladder denervation, electrosti mulation, local treatment with botulinum toxin) and the surgical thera py (sacral deafferentation and anterior root stimulation, bladder neck closure and cystostomy, sphincterotomy or augmentation cystoplasty) m ust be reserved for special cases.