Diagnosis and Management of LUTS in MS, PD, and Spinal Injuries

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The American Urogynecologic Society's educational program, led by Dr. Yahir Santiago-Lastra, focuses on the diagnosis and management of Lower Urinary Tract Symptoms (LUTS) in patients with neurological conditions such as Multiple Sclerosis (MS), Parkinson’s Disease (PD), and spinal injuries. This comprehensive educational initiative highlights the critical importance of addressing neurogenic lower urinary tract dysfunction to prevent upper tract deterioration and improve patient quality of life.<br /><br />The program's main objectives include understanding the pathophysiology of LUTS in neurological conditions, identifying key diagnostic approaches, tailoring management strategies for specific populations, emphasizing multidisciplinary collaboration, and exploring innovations in LUTS management for neurological disorders. These steps are crucial since neurogenic LUT dysfunction can lead to serious conditions like hydronephrosis and urinary infections, and significantly impact patients' quality of life through symptoms like incontinence and urinary retention.<br /><br />The standard lower urinary tract function involves low-pressure urine storage and a coordinated emptying phase managed by both autonomic and somatic nervous systems. In cases of neurogenic dysfunction, this coordination is disrupted, requiring a detailed history, physical exam, urinalysis, and potentially urodynamic evaluations for effective diagnosis and management.<br /><br />Key management strategies include lowering storage pressures to protect the upper urinary tract, improving bladder compliance, enhancing emptying, and addressing incontinence with treatments such as medication, clean intermittent catheterization, and intravesical botulinum toxin injections. Treatment plans should be personalized based on urodynamic findings and the patient's neurologic and functional status, in conjunction with their specific goals.<br /><br />Multidisciplinary approaches are strongly advocated, involving collaborations among neurology, urology, and rehabilitation specialists, to ensure optimal treatment outcomes for neurogenic bladder conditions.

Keywords

Urogynecology

Lower Urinary Tract Symptoms

Neurological Conditions

Neurogenic Bladder

Multidisciplinary Collaboration

Urodynamic Evaluation

Bladder Compliance

Intravesical Botulinum Toxin

Patient Quality of Life

Upper Tract Protection