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Purpose of Review <p>Neurogenic lower urinary tract dysfunction encompasses a range of symptoms and is often seen alongside bladder outlet obstruction in older men. Management of these patients requires individualized care that addresses both conditions, focusing on preserving renal function, reducing infections, and improving quality of life. Current guidelines offer limited guidance for this complex population. The authors propose a systematic diagnostic approach encompassing patient history, urodynamics, and diagnostic tools.</p> Recent Findings <p>Urodynamics are emphasized for tailoring management strategies and distinguishing between neurogenic and obstructive causes. While neurogenic bladder patients have been underrepresented in studies on bladder outlet surgery due to concerns about higher complication rates, evidence suggests that surgical interventions can improve symptoms, including incontinence and catheter dependence.</p> Summary <p>We review the limited evidence in the literature and propose a diagnostic strategy for this complex patient population. The authors stress the importance of individualized evaluation and guidance for a general urology practice, especially when referral to specialized centers is advised.</p>

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Should I Perform a Bladder Outlet-Relieving Procedure in Men with Urinary Retention and Neurogenic Lower Urinary Tract Dysfunction?

  • 期刊论文

  • 发表日期：

    2025年3月14日

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  • Laena Hines,
  • Carl Ceraolo,
  • Scott Quarrier,
  • Gareth Warren,
  • Rajat Jain

摘要

Purpose of Review

Neurogenic lower urinary tract dysfunction encompasses a range of symptoms and is often seen alongside bladder outlet obstruction in older men. Management of these patients requires individualized care that addresses both conditions, focusing on preserving renal function, reducing infections, and improving quality of life. Current guidelines offer limited guidance for this complex population. The authors propose a systematic diagnostic approach encompassing patient history, urodynamics, and diagnostic tools.

Recent Findings

Urodynamics are emphasized for tailoring management strategies and distinguishing between neurogenic and obstructive causes. While neurogenic bladder patients have been underrepresented in studies on bladder outlet surgery due to concerns about higher complication rates, evidence suggests that surgical interventions can improve symptoms, including incontinence and catheter dependence.

Summary

We review the limited evidence in the literature and propose a diagnostic strategy for this complex patient population. The authors stress the importance of individualized evaluation and guidance for a general urology practice, especially when referral to specialized centers is advised.