Unlocking Hidden Struggles: Neurogenic LUT Dysfunction

75% patients with multiple sclerosis after 10 years

1. Sartori AM, Kessler TM, Castro-Díaz DM, et al. Summary of the 2024 Update of the European Association of Urology Guidelines on Neurourology. Eur Urol. 2024;85(6):543–555.
2. Werneburg GT, Welk B, Averbeck MA, et al. Neuro-urology: Call for universal, resource-independent guidance. Biomedicines. 2023;11(2):397.

96% patients with spina bifida

1. Sartori AM, Kessler TM, Castro-Díaz DM, et al. Summary of the 2024 Update of the European Association of Urology Guidelines on Neurourology. Eur Urol. 2024;85(6):543–555.
2. Werneburg GT, Welk B, Averbeck MA, et al. Neuro-urology: Call for universal, resource-independent guidance. Biomedicines. 2023;11(2):397.

50% of those with parkinsonian syndrome at disease onset

1. Sartori AM, Kessler TM, Castro-Díaz DM, et al. Summary of the 2024 Update of the European Association of Urology Guidelines on Neurourology. Eur Urol. 2024;85(6):543–555.
2. Werneburg GT, Welk B, Averbeck MA, et al. Neuro-urology: Call for universal, resource-independent guidance. Biomedicines. 2023;11(2):397.

95% patients following spinal cord injury

1. Sartori AM, Kessler TM, Castro-Díaz DM, et al. Summary of the 2024 Update of the European Association of Urology Guidelines on Neurourology. Eur Urol. 2024;85(6):543–555.
2. Werneburg GT, Welk B, Averbeck MA, et al. Neuro-urology: Call for universal, resource-independent guidance. Biomedicines. 2023;11(2):397.

75% patients following stroke

1. Sartori AM, Kessler TM, Castro-Díaz DM, et al. Summary of the 2024 Update of the European Association of Urology Guidelines on Neurourology. Eur Urol. 2024;85(6):543–555.
2. Werneburg GT, Welk B, Averbeck MA, et al. Neuro-urology: Call for universal, resource-independent guidance. Biomedicines. 2023;11(2):397.

EAU 2024 Recommendations for Diagnosis of Neurourological Disorders

Early diagnosis is crucial to prevent complications and permanent damage

Detailed history

Take a thorough history, focusing on urinary, sexual, and bowel symptoms Identify warning signs such as pain, infection, and fever
Evaluate bladder diaries
Assess quality of life

Sartori AM, Kessler TM, Castro-Díaz DM, et al. Summary of the 2024 Update of the European Association of Urology Guidelines on Neurourology. Eur Urol. 2024;85(6):543–555.

EAU 2024 Recommendations for Diagnosis of Neurourological Disorders

Early diagnosis is crucial to prevent complications and permanent damage

Physical examination

All sensations and reflexes in the urogenital area
Urinalysis, ultrasonography, blood tests, and urodynamic evaluations are crucial for comprehensive management

Sartori AM, Kessler TM, Castro-Díaz DM, et al. Summary of the 2024 Update of the European Association of Urology Guidelines on Neurourology. Eur Urol. 2024;85(6):543–555.

EAU 2024 Recommendations for Diagnosis of Neurourological Disorders

Early diagnosis is crucial to prevent complications and permanent damage

Urodynamics

Repeat free uroflowmetry and residual urine assessments 2–3 times in patients able to void.
Use video-urodynamics for invasive urodynamics, ensuring BP and heart rate monitoring throughout.

Sartori AM, Kessler TM, Castro-Díaz DM, et al. Summary of the 2024 Update of the European Association of Urology Guidelines on Neurourology. Eur Urol. 2024;85(6):543–555.

EAU 2024 Recommendations for Diagnosis of Neurourological Disorders
Combinations such as drug treatment and catheterization is often used to protect the urinary tract and improve outcomes.

Drugs for storage symptoms

Drugs for storage symptoms

Antimuscarinic drugs: First-line choice for NDO treatment
β3-adrenergic receptor agonists: Improve symptoms and QoL in NDO patients
Other treatments: Desmopressin, cannabinoids, and tadalafil

Sartori AM, Kessler TM, Castro-Díaz DM, et al. Summary of the 2024 Update of the European Association of Urology Guidelines on Neurourology. Eur Urol. 2024;85(6):543–555.

EAU 2024 Recommendations for Diagnosis of Neurourological Disorders
Combinations such as drug treatment and catheterization is often used to protect the urinary tract and improve outcomes.

Drugs for voiding symptoms

Drugs for voiding symptoms

Alpha-blockers: Reduce bladder outlet resistance, PVR, and AD

Sartori AM, Kessler TM, Castro-Díaz DM, et al. Summary of the 2024 Update of the European Association of Urology Guidelines on Neurourology. Eur Urol. 2024;85(6):543–555.

EAU 2024 Recommendations for Diagnosis of Neurourological Disorders
Combinations such as drug treatment and catheterization is often used to protect the urinary tract and improve outcomes.

Catheterization

Catheterization

Use intermittent catheterisation as a standard treatment for patients who are unable to empty their bladder.
Avoid indwelling transurethral and suprapubic catheterisation whenever possible.

Sartori AM, Kessler TM, Castro-Díaz DM, et al. Summary of the 2024 Update of the European Association of Urology Guidelines on Neurourology. Eur Urol. 2024;85(6):543–555.

EAU 2024 Recommendations for Diagnosis of Neurourological Disorders
Combinations such as drug treatment and catheterization is often used to protect the urinary tract and improve outcomes.

Follow-up

Assess the upper urinary tract and perform urodynamic investigations at regular intervals in high-risk patients.
Perform a physical examination and urine laboratory every year in high-risk patients.

Sartori AM, Kessler TM, Castro-Díaz DM, et al. Summary of the 2024 Update of the European Association of Urology Guidelines on Neurourology. Eur Urol. 2024;85(6):543–555.

Abbreviations ▼

AD: Autonomic dysreflexia; NDO: Neurogenic detrusor overactivity; PVR: Postvoid residual volume; UTI: Urinary tract infection.

LMRC Code: GGI-CO-A1-AQS-300020632-BANNERS-G24-0884

Alfoo-Improved Pharmacokinetics

ALFOO, containing Alfuzosin molecule, is Anti-BPH which helps in treatment of LUTS due to BPH in Young Sexually Active Male in 40-60 year old age group