[Short version of the S2k guideline on drug therapy of neurogenic lower urinary tract dysfunction (NLUTD)].

Background: In Germany about one million patients suffer from neurogenic lower urinary tract dysfunction (NLUTD). If left untreated, various forms of NLUTD can lead to secondary damage of the lower and upper urinary tract. Thus, the guideline was developed for the drug therapy of patients with NLUTD, who frequently require lifelong care and aftercare.

The Real Daily Need for Incontinence Aids and Appliances in Patients with Neurogenic Bladder Dysfunction in a Community Setting in Germany.

Purpose: For successful long-term rehabilitation of patients with neurogenic lower urinary tract dysfunction (NLUTD), it is necessary to define the objective requirement for urological aids based on a scientifically validated basis.

Methods: This was a cross-sectional multicenter study, based on a questionnaire. Data concerning bladder management and daily consumption of urological appliances for patients with NLUTD in a community setting were collected through a standardized survey.

Effect of spinal anterior root stimulation and sacral deafferentation on bladder and sexual dysfunction in spinal cord injury.

Background: Spinal cord injury (SCI) is a highly devastating injury with a variety of complications; among them are neurogenic bladder, bowel, and sexual dysfunction. We aimed to evaluate the effect of sacral anterior root stimulation with sacral deafferentation (SARS-SDAF) on neurogenic bladder and sexual dysfunction in a large well-defined spinal cord injury cohort.

Methods: In the manner of cross-sectional study, subjects undergone SARS-SDAF between September 1986 and July 2011 answered a questionnaire concerning conditions before and after surgery in the department of Neuro-Urology, Bad Wildungen, Germany.

[Objective and subjective requirement of aids and appliances in patients with neurogenic lower urinary tract dysfunction : Multicenter study to determinate the daily necessity of urological aids and appliances].

Background: The provision of urological appliances for patients with neurogenic lower urinary tract dysfunction (NLUTD) is essential. Hitherto existing standard guidelines for the estimation of monthly material requirements are based solely on estimates.

Objective: The goal of this work was to define the objective and subsequently subjective requirements for urological appliances on a scientifically validated basis.

Sacral anterior root stimulation improves bowel function in subjects with spinal cord injury.

Study Design: Cross-sectional study.

Objective: To evaluate the long-term effect of the sacral anterior root stimulator (SARS) on neurogenic bowel dysfunction in a large, well defined spinal cord injury (SCI) cohort.

Setting: Department of Neuro-Urology, Bad Wildungen, Germany.

[Modern neurological treatment strategies for patients with spinal cord injury].

Modern treatment methods for neurogenic bladder dysfunction take into consideration the primacy of obtaining good bladder storage capacity by merely lowering the leak point pressure. The medical benefit for the patient is seen in the stability of renal function and the social advantage in achieving continence. The development of modern findings on the management of neuro-urological disorders in spinal cord injury as well as the underlying principles, indications, and benefits of the most frequently applied treatment approaches are described.

Clinical evaluation of a newly developed catheter (SpeediCath Compact Male) in men with spinal cord injury: residual urine and user evaluation.

Objective: To evaluate the performance of a new 30-cm-long, telescoping male intermittent catheter (SpeediCath Compact Male; Coloplast A/S, Humlebæk, Denmark) in urinary bladder emptying, safety and subject acceptance vs a standard-length male intermittent catheter (SpeediCath).

Materials And Methods: In a prospective, randomized, multicenter, crossover non-inferiority study, 37 male intermittent catheter users self-catheterized three times with the test catheter on one test day and three times with the standard-length male (reference) catheter on another test day. Residual urine (RU) volume in the bladder after catheterization was measured by ultrasound.

Treatment outcomes and resource use of patients with neurogenic detrusor overactivity receiving botulinum toxin A (BOTOX) therapy in Germany.

Purpose: To evaluate treatment outcomes and resource consumption of patients with neurogenic detrusor overactivity (NDO) before and after botulinum toxin A (Botox) therapy in Germany.

Methods: In a multi-center, cross-sectional, retrospective cohort study, data of patients with NDO 12 months before and after the first Botox therapy were analyzed.

Results: 214 patients (mean age 38 +/- 14.

[Neurogenic urinary incontinence. Value of surgical management].

Damage to the CNS, the cauda equina, and the pelvic nerval structures causes neurogenic bladder dysfunction with neurogenic urinary incontinence (NUI). The definitive diagnosis of NUI is made with urodynamic examination methods. The most frequent cause of NUI is neurogenic detrusor overactivity (NDO).

Surgical therapy of neurogenic detrusor overactivity (hyperreflexia) in paraplegic patients by sacral deafferentation and implant driven micturition by sacral anterior root stimulation: methods, indications, results, complications, and future prospects.

Spinal cord injured patients with a suprasacral lesion usually develop a spastic bladder. The neurogenic detrusor overactivity (NDO) and the overactive external sphincter cause incontinence and threaten these patients with recurrent urinary tract infections (UTI), renal failure and autonomic dysreflexia. All of these severe disturbances may be well managed by sacral deafferentation (SDAF) and implantation of a sacral anterior root stimulator (SARS).

[Botulinum toxin for the treatment of neurogenic detrusor hyperactivity. Consensus paper on use for neurogenic bladder dysfunction].

Due to elevated intravesical storage pressures, neurogenic bladder dysfunction carries a high risk of renal damage. Thus, the goals of neurourologic treatment are reduction of intravesical storage pressure and intermittent bladder emptying in order to protect renal function and to achieve continence. If anticholinergic medication is either ineffective or intolerable, several open and controlled studies showed that the injection of botulinum toxin A into the detrusor muscle is a minimally invasive, safe, and effective treatment option.

Penile prosthetic surgery in neurologically impaired patients: long-term followup.

Purpose: Penile prosthetics are a viable option for erectile dysfunction in neurologically impaired patients. Penile implants can also be used to facilitate the management of urinary drainage when penile retraction has made this difficult.

Materials And Methods: Between 1980 and 1996, 245 neurologically impaired patients with a mean age of 40.

[Neurourology. Current developments and therapeutic strategies].

There is no part of urology that has made so much progress in the last 25 years as neurourology. Seminal developments have been made in the selective effectiveness of drugs influencing neurogenic bladder dysfunction but having limited side effects. Additional advances are also likely to be made in the methods of functional electrostimulation and tissue engineering.

Spastic bladder and spinal cord injury: seventeen years of experience with sacral deafferentation and implantation of an anterior root stimulator.

Introduction: Spinal cord injured patients with a suprasacral lesion usually develop a spastic bladder. The hyperreflexia of the detrusor and the external sphincter causes incontinence and threatens those patients with recurrent urinary tract infections (UTI), renal failure, and autonomic dysreflexia. All of these severe disturbances may be well managed by sacral deafferentation (SDAF) and implantation of an anterior root stimulator.

Penile prostheses in paraplegic men.

Objectives: To determine the efficacy of penile prostheses in paraplegic men.

Patients And Methods: Between 1980 and 1992, penile prostheses were implanted in 209 paralysed men of whom the records of 179 were evaluable. The indication for implantation was erectile dysfunction, penile retraction, or a combination of the two.

Wallstents in patients with detrusor-sphincter dyssynergia.

Purpose: For patients with spinal cord injuries who are unable to perform clean intermittent self-catheterization, sphincterotomy is performed most commonly to avoid high bladder pressure. This procedure causes additional trauma and does not always lead to a satisfactory result. Therefore, we sought an alternative therapy.