Pelvic Organ Dysfunction in Neurological Disease: Clinical Management and Rehabilitation

Half-title......Page 3
Title......Page 5
Copyright......Page 6
Contents......Page 7
Contributors......Page 9
Foreword......Page 13
Preface......Page 15
Peripheral control of micturition......Page 17
The detrusor muscle......Page 18
The urothelium and suburothelium......Page 19
Afferent pathway changes: the vanilloid and purinergic pathways......Page 21
Cholinergic pathway changes......Page 23
Detrusor underactivity......Page 24
Spinal control of bladder function......Page 25
Spinal reflexes and bladder pathophysiology......Page 26
Current concepts of brain control of the bladder......Page 27
Bladder sensation and the concept of \"interoception\"......Page 28
Prefrontal cortex and bladder control......Page 30
Circuit 2: safety (limbic)......Page 32
Circuit 3: social (cortical/cingulate)......Page 33
References......Page 35
The pelvic floor and anal sphincter complex......Page 41
The intrinsic (enteric) nervous system......Page 42
Parasympathetic innervation......Page 43
Sympathetic innervation......Page 44
Colonic activity......Page 45
Cerebral control of bowel function......Page 46
Abdominal pain......Page 48
Gut motility and the gastrocolic reflex......Page 49
Anorectal manometry and dysfunction......Page 50
Compliance......Page 51
References......Page 52
Physiology of sexual functions......Page 56
Female sexual response......Page 57
Human data......Page 58
Neuroendocrine effects......Page 59
Temporal lobes and amygdala......Page 60
Parietal......Page 61
Functional brain imaging of sexual activity......Page 62
Imaging of sexual excitement......Page 63
Imaging of orgasm......Page 65
Brainstem and spinal cord......Page 66
Male genital innervation......Page 69
Female genital innervation......Page 71
Conclusion......Page 72
References......Page 73
History......Page 77
Storage symptoms......Page 78
Incontinence......Page 79
Symptoms of upper urinary tract damage......Page 81
Bladder diary......Page 82
\"Dipstick\" urine analysis......Page 83
Blood tests......Page 84
Urodynamics......Page 85
Filling cystometry and pressure flow studies......Page 86
Videourodynamics......Page 87
Electromyography......Page 88
Management......Page 89
Multidisciplinary approach to lower urinary tract dysfunction......Page 90
References......Page 92
Initial assessment......Page 95
Rationale for PFM training in detrusor overactivity......Page 96
Posterior tibial nerve stimulation......Page 97
Intermittent catheterization......Page 98
Indwelling catheterization......Page 99
Urine drainage bags......Page 100
Catheter valves......Page 101
Absorbent products......Page 102
References......Page 103
Scientific background - mechanism of action......Page 105
Clinical efficacy......Page 106
Efficacy in NDO......Page 108
Side-effects......Page 109
Existing recommendations......Page 110
Scientific background......Page 111
Scientific background......Page 112
Intravesical treatments......Page 113
Clinical efficacy and safety of intravesical vanilloids......Page 114
Scientific background......Page 115
Scientific background......Page 116
Procedure......Page 118
Existing recommendations......Page 119
References......Page 120
Intravesical electrostimulation......Page 128
Results......Page 129
Sacral anterior root stimulation with sacral deafferentation......Page 130
Urinary tract reconstructive surgery......Page 131
Surgical technique......Page 133
Future possibilities......Page 134
Surgical techniques......Page 135
Stents......Page 136
Adjustable continence therapy (ACT)......Page 137
Suprapubic catheter (SPC)......Page 138
References......Page 139
Evaluation......Page 143
International bowel function spinal cord injury data sets......Page 144
Colorectal transit times......Page 150
Anorectal physiology......Page 151
References......Page 152
Impact on quality of life......Page 154
Clinical assessment for bowel management......Page 155
Investigational assessment for bowel management......Page 156
Management of fecal impaction......Page 157
Specific management of neurogenic bowel dysfunction......Page 158
Abdominal massage......Page 159
Digital rectal stimulation......Page 160
Suppositories and enemas......Page 161
Putting a bowel management program together......Page 162
Transanal irrigation......Page 163
Sacral anterior root stimulator (SARS)......Page 164
References......Page 165
Sexual dysfunction in neurological disorders......Page 169
Evaluation of sexual dysfunction......Page 170
Sensory testing......Page 172
General measures......Page 173
First-line treatment......Page 175
Second-line treatment......Page 176
Treatment options for women......Page 177
Future perspectives......Page 178
References......Page 179
Bladder......Page 183
Bowel......Page 187
Temporal lesions......Page 188
Hypothalamic and septal regions......Page 190
Bladder and bowel......Page 191
Ansa lenticularis and globus pallidus......Page 192
Bladder......Page 193
Bladder......Page 194
Sexual behavior......Page 203
Dementia......Page 204
Sexual behavior......Page 205
References......Page 206
Bowel dysfunction......Page 211
Lower gastrointestinal tract symptoms......Page 213
Recto-anal videomanometry and sphincter electromyography......Page 214
Medication for bowel symptoms......Page 215
Surgery for prostate disease in men with PD......Page 216
Correlation with severity of neurological disease......Page 217
Underlying pathophysiology of symptoms......Page 218
Bladder symptoms and PD therapies......Page 219
Investigations......Page 220
Flow rate, residual volume and cystometry......Page 221
Sexual dysfunction in PD......Page 222
References......Page 224
Detrusor overactivity......Page 230
Open bladder neck......Page 232
Neurogenic changes in sphincter electromyography (EMG)......Page 233
Differential diagnosis of PD and MSA-P......Page 234
Other medications......Page 235
Bowel symptoms......Page 236
Weak sphincter......Page 237
Sexual symptoms......Page 238
References......Page 241
Introduction......Page 244
Symptoms......Page 245
Physical treatments......Page 246
Clean intermittent self-catheterization (CISC)......Page 247
Antimuscarinics......Page 248
Detrusor injection of botulinum toxin A......Page 249
Surgical treatments......Page 250
Follow-up review......Page 251
Constipation......Page 252
Conclusions......Page 253
Pathophysiology of SD in men......Page 254
Treatments for men......Page 255
Addressing secondary and tertiary sources of SD in men and women......Page 256
References......Page 259
\"Spinal shock\"......Page 265
Autonomic dysreflexia......Page 266
Assessment and investigations in \"chronic phase\"......Page 267
Ureteric reflux......Page 268
Prolapse......Page 270
Medications......Page 271
Bladder augmentation (clam cystoplasty)......Page 272
Bowel......Page 273
Ejaculation......Page 274
Pregnancy......Page 275
References......Page 276
Pathogenesis......Page 279
Assessment......Page 281
Treatment......Page 282
Antimuscarinic therapy......Page 283
Assessment......Page 284
Treatment......Page 285
Tethered cord syndrome......Page 286
References......Page 287
Epidemiology and causes of cauda equina damage......Page 290
Acute causes of CES......Page 291
Causes of chronic CES......Page 294
Pelvic organ dysfunction......Page 296
Bladder......Page 297
Management......Page 298
Acknowledgement......Page 299
References......Page 300
Diabetes mellitus......Page 302
Guillain-Barre syndrome......Page 304
Pelvic nerve injury......Page 305
Cystectomy and prostatectomy......Page 306
Neurosyphilis......Page 307
Pudendal neuralgia......Page 308
Familial amyloid polyneuropathy......Page 310
Porphyria......Page 311
References......Page 312
Functional urinary retention with associated neurological dysfunction......Page 317
Fowlers syndrome (FS)......Page 319
Clinical features and investigations......Page 321
Pathogenesis of retention......Page 322
Opiates and voiding dysfunction......Page 325
Appendix 2:\n  Surveys and questionnaires......Page 0
Selection of patients with retention for SNM......Page 328
References......Page 329
Evaluation and management of lower urinary tract dysfunction......Page 331
Evaluation and management of sexual dysfunction......Page 332
Algorithm for neurogenic bowel evaluation and management......Page 333
Algorithm for constipation......Page 334
Algorithm for fecal incontinence......Page 335
Incontinence Impact Questionnaire 7 (1)......Page 336
International Prostate Symptom Score (IPSS) (2)......Page 337
Urinary Symptom Profile - USP(3)......Page 338
SF-Qualiveen (4)......Page 340
International Index of Erectile Function (IIEF) (5)......Page 342
CHECK ONLY ONE BOX PER QUESTION.......Page 345
The Neurogenic Bowel Dysfunction (NBD) score (8)......Page 348
Index......Page 350