Conservative therapy of non-neurogenic lower urinary tract Conservative therapy of neurogenic lower urinary tract dysfunctions - 2nd part
Abstract
Possibilities of pharmacological and non-pharmacological therapy of neurogenic lower urinary tract dysfunctions are presented. Neurogenic lesions leading to lower urinary tract dysfunctions can be divided into suprapontine, infrapontine, and sacral and peripheral lesions.
Due to the complexity of neurogenic disorders, it is necessary to base treatment on urodynamics results. The aim of therapy of neurogenic lower urinary tract dysfunctions is to protect the upper urinary tract, achieve continence, ensure adequate evacuation of bladder, and improve patients' quality of life.
Combination of non-pharmacological treatment and pharmacotherapy is usually applied. Intermittent catheterization is cornerstone of non-pharmacological treatment lower urinary tract dysfunction with inadequate evacuation of bladder.
Oral anticholinergics dominates in pharmacotherapy of detrusor overactivity. Intravesical application of botulinum toxin acquires an increasing role in case of insufficient effect of oral anticholinergics.