Recent advances in the management of the neurogenic bladder

Proper evaluation of the neurogenic bladder remains the cornerstone for acc urate management of the neurologically impaired patient. Due to the inheren t progressive nature of many neurologic disorders causing bladder dysfuncti on and lack of targeted medical therapy, much work has been done and needs to be done to advance the management of this often-difficult patient popula tion. This article reviews the latest advances in managing the neurogenic b ladder. For ease of review, the neurogenic bladder can be divided into 2 ba sic categories: first, bladders that fail to empty successfully and, second , those that fail to store urine adequately. Therapy should be based on the se categories because poor therapeutic results are seen when a standard tre atment is prescribed for the wrong bladder condition. Given the success of other specialties (physical medicine and rehabilitation, orthopedics, and n eurology) at improving and prolonging the lives of the neurologically impai red patient, the urologist has an increasing responsibility to evaluate and treat the neurogenic bladder effectively over a life span that is approach ing that of the normal population. UROLOGY 56 (Suppl 6A): 76-81, 2000. (C) 2000, Elsevier Science Inc.