|Bladder Dysfunction in Peripheral Neuropathies|
by Ahmet Z. Burakgazi, MD, Bander Alsowaity, MD, Zeynep Aydin Burakgazi, BS, Dogan Unal, MD, John J. Ke
Available to Members ONLY - Members Free CME - Normal bladder function depends on the complex interaction of sensory and motor pathways. Bladder dysfunction can develop as a result of several neurological conditions. It can happen in a number of ways including diabetic cystopathy, detrusor overactivity, bladder outlet obstruction, and urge and stress urinary incontinence. Diabetic neuropathy is the most common cause for peripheral neuropathy-associated bladder dysfunction. Guillain-Barre Syndrome (GBS), Human immunodeficiency virus (HIV) -associated neuropathy, chronic inflammatory demyelinating polyneuropathy (CIDP), and amyloid neuropathy are other important causes. The diagnosis of bladder dysfunction should be established by the history of neurologic symptoms, neurologic examination, and urological evaluation. Functional evaluation of the lower urinary tract includes cystometry, sphincter electromyography, uroflowmetry, and urethral pressure profilometry. Management of urinary symptoms in patients with bladder dysfunction is usually supportive. In some cases, alpha-blocker and/or anti-muscarinic agents are needed to help improve urinary dysfunction. Intermittent self-catheterization occasionally is needed for patients with slow and/or poor recovery.
The AANEM designates this enduring material for a maximum of 2 AMA PRA Category 1 Credits TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Credit expires 1/1/15.
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