From the Guidelines
The diagnostic approach for neurogenic bladder should begin with a detailed history, physical exam, and urinalysis, as recommended by the AUA/SUFU guideline on adult neurogenic lower urinary tract dysfunction 1. This initial evaluation is crucial in directing subsequent assessment and management, and it should include factors such as cognitive ability, upper and lower extremity function, spasticity, dexterity, mobility, supportive environment, and prognosis from the neurological condition. Some key points to consider in the diagnostic approach include:
- A thorough medical history to identify underlying neurological conditions and urinary symptoms
- Physical examination to assess cognitive and physical function
- Urinalysis to rule out infection and other conditions
- Urodynamic studies, such as uroflowmetry, cystometry, and pressure-flow studies, to assess bladder function and coordination
- Post-void residual measurement to determine if the bladder empties completely
- Imaging studies, such as ultrasound, CT, or MRI, to assess the upper urinary tract and identify structural abnormalities
- Neurological testing, including electromyography of pelvic floor muscles, to determine the specific neurological deficit
- Voiding diaries to document urinary patterns over time The goal of this comprehensive evaluation is to determine the type and severity of neurogenic bladder dysfunction, which is essential for developing an effective management plan, as noted in the AUA/SUFU guideline 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Diagnostic Approach for Neurogenic Bladder
The diagnostic approach for neurogenic bladder involves a combination of clinical examinations, urodynamic tests, and radiographic imaging studies.
- Full clinical examinations are essential to best manage patients with neurogenic bladder 2.
- Urodynamic tests are the definitive test for diagnosis and management of neurogenic bladder dysfunction 3.
- Urodynamic testing provides key information when assessing effectiveness of treatments and is helpful for risk stratification in patients with neurogenic bladders 4.
Urodynamic Testing
Urodynamic testing is a crucial component of the diagnostic approach for neurogenic bladder.
- It involves the measurement of detrusor pressures to assess the risk of infectious and renal complications 4.
- Urodynamic evaluation plays a key role in risk stratifying individuals for renal deterioration, particularly in infants with myelomeningocele 5.
- The test can help identify conditions such as detrusor sphincter dyssynergia, although the diagnosis of this condition can be challenging, especially in infants 5.
Radiographic Imaging Studies
Radiographic imaging studies are also an important part of the diagnostic approach for neurogenic bladder.
- These studies can help identify complications such as upper urinary tract dilatation and renal failure 2.
- They can also provide information on the structure and function of the urinary tract, which can be useful in managing patients with neurogenic bladder 3.
Clinical Evaluation
Clinical evaluation is essential in the diagnosis and management of neurogenic bladder.
- A thorough clinical examination can help identify symptoms and signs of neurogenic bladder, such as urinary incontinence and retention 2.
- Clinical evaluation can also help identify underlying conditions that may be contributing to the development of neurogenic bladder, such as spinal cord injury or multiple sclerosis 6.