Consensus document on the multidisciplinary management of neurogenic lower urinary tract dysfunction in patients with multiple sclerosis.
Consensus
Delphi Technique
Disease Management
Disease Progression
Humans
Lower Urinary Tract Symptoms
/ etiology
Multiple Sclerosis
/ complications
Neurology
Patient Care Team
Quality of Life
Referral and Consultation
Risk Factors
Urinary Bladder, Neurogenic
/ etiology
Urinary Incontinence
/ etiology
Urinary Tract Infections
/ etiology
Urodynamics
Urologic Surgical Procedures
Urology
consensus
multidisciplinary care
multiple sclerosis
neurogenic lower urinary tract dysfunction
Journal
Neurourology and urodynamics
ISSN: 1520-6777
Titre abrégé: Neurourol Urodyn
Pays: United States
ID NLM: 8303326
Informations de publication
Date de publication:
02 2020
02 2020
Historique:
received:
19
11
2019
accepted:
30
12
2019
pubmed:
17
1
2020
medline:
22
10
2020
entrez:
17
1
2020
Statut:
ppublish
Résumé
Neurogenic lower urinary tract dysfunction (NLUTD) is very common in multiple sclerosis (MS) patients. Early diagnosis and treatment are crucial to avoid irreversible damage and improve quality of life. Our aim was to develop recommendations to improve NLUTD identification in MS patients, along with their referral and management. A multidisciplinary group of 14 experts in the management of patients with MS and NLUTD (nine urologists, three neurologists, and two rehabilitators) was selected. A comprehensive review of the literature was undertaken and a set of recommendations was generated and submitted to a Delphi panel of 114 experts. Recommendations were presented according to the grade of agreement (GA). Early diagnosis in asymptomatic patients with risk factors for complications is recommended (GA 94%). Postvoid residual volume should be measured if changes in urinary symptoms (GA 87%), preferably ultrasound-guided (GA 86%). Early referral to urologist is recommended if urinary incontinence (GA 91%), significant post-void residual volume (94%), quality of life impairment (GA 98%) and recurrent urinary infections (GA 97%). The initial evaluation should include physical examination (GA 99%) and urodynamics including cystometry (GA 89%), pressure-flow study (90%) and electromyography (GA 70%). The panel recommends multidisciplinary collaboration (GA 100%) with a rehabilitation specialist and trained nurses in the management of NLUTD (GA 99%). Multidisciplinary management for patients with NLUTD due to MS is advised, including urologists, neurologists, rehabilitation, and nurses. Panel recommends early diagnosis with post-void residual volume in symptomatic patients before referring to urologist and urodynamics when referred.
Types de publication
Consensus Development Conference
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
762-770Informations de copyright
© 2020 Wiley Periodicals, Inc.
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