Epidemiology of Neuro-Urological Disorders Flashcards
Suprapontine and pontine lesions and diseases
CVA strokes Dementias - Alzheimers, Vascular Parkinsonian syndrome Brain tumors Cerebral Palsy Traumatic Brain Injury Normal pressure HCP
Lesions and diseases between caudal brainstem and sacral spinal cord
SCI
Spina bifida
Lesions and diseases of the PNS
Lumbar spine Degenerative disease Disk prolapse Lumbar canal stenosis Iatrogenic pelvic nerve lesions Peripheral neuropathy Diabetes
Disseminated central diseases
Multiple sclerosis
Type and Frequency of Neuro-Urological Symptoms
CVA
Nocturia
OAB
Urgency Urinary Incontinence
DO
Type and Frequency of Neuro-Urological Symptoms
Dementias
OAB
UUI
DO
Type and Frequency of Neuro-Urological Symptoms
Parkinsons
Urgency
Nocturia
Type and Frequency of Neuro-Urological Symptoms
Brain tumors
Incontinence occurs mainly in frontal location
Type and Frequency of Neuro-Urological Symptoms
Cerebral palsy
Urinary incontinence
Type and Frequency of Neuro-Urological Symptoms
Traumatic brain injury
44% storage dysfunction
38% voiding dysfunction
60% urodynamic abnormalities
Type and Frequency of Neuro-Urological Symptoms
Normal pressure HCP
Urinary incontinence in 98-100% of patients
Associated with gait and cognitive disturbance.
Type and Frequency of Neuro-Urological Symptoms
SPINAL CORD INJURY
NEUROGENIC DETRUSOR OVERACTIVITY
DETRUSOR SPHINCTER DYSSNERGIA (95%)
may also have DUA depending on the level of the lesion
Type and Frequency of Neuro-Urological Symptoms
Spina bifida
Urinary incontinence
Type and Frequency of Neuro-Urological Symptoms
Multiple sclerosis
10% at presentation
75% 10 years after
DO 86%
DSD 35%
DUA 25%
Suprapontine lesion
History:
Ultrasound:
Urodynamics:
Suprapontine lesion
History: STORAGE SYMPTOMS predominantly
Ultrasound: insignificant PVR
Urodynamics: DO
Bladder: overactive
Sphincter: normoactive
Spinal (infrapontine-suprasacral) lesion
History:
Ultrasound:
Urodynamics:
Bladder:
Sphincter:
Spinal (infrapontine-suprasacral) lesion
History: BOTH storage and voiding symptoms
Ultrasound: PVR increased
Urodynamics: DO, DSD
Bladder: Overactive
Sphincter: Overactive
Sacral/infrasacral lesion:
History:
Ultrasound:
Urodynamics:
Bladder:
Sphincter:
Sacral/infrasacral lesion:
History: predominantly VOIDING
Ultrasound: PVR increased
Urodynamics: hypocontractile or acontractile
Bladder: Underactive
Sphincter: Normoactive or Underactive
Sudden and exaggerated autonomic response to various stimuli in patients with SCI or spinal dysfunction
Autonomic dysreflexia
Generally manifests above level Th6
Systolic BP change in autonomic dysreflexia
> 20mmHG from baseline
