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Neurogenic urination disorders: diagnostic methods


Neurogenic disorders of urination are typical manifestation of most neurologic diseases and observed in 10-90% of patients, depending on the nature and extent of damage to the nervous system [1,3,7,10,15]. These disorders are functional in nature and are a reflection of the processes occurring in the nervous system (mainly in its Central division). For each specific neurological disease is characterized by individual symptom and distinctive pathogenetic mechanisms shaping them [6]. The reasons for the formation of persistent pathological reflexes of urination are to defeat centers of urination (ischemic stroke, brain tumors and spinal cord), violation of nerve impulses from receptors in the bladder and urethra to cortical, subcortical, stem or spinal centres of urination (multiple sclerosis, subcortical arteriosclerotic encephalopathy), degenerative changes of the nervous system and imbalance of neurotransmitters (Parkinson's disease, Multisystem atrophy) [11,13,16].

Рис. 4. Основные эффекты лекарственных средств, применяемых в нейроурологической практике

Analysis of treatment results is the final diagnostic step. For example, application specific peripheral competitive antagonist of the muscarinic receptors of the 2nd and 3rd subtype of trospium chloride reduces the severity of symptoms GUMP in Parkinson's disease, at the same time arresting selorejo and spastic constipation, indicates that the leading mechanism of these three, at first glance, independent of the symptoms of Parkinson's disease is parasympathicotonia developing, usually for 5-7 year from the onset of the disease.


Neurogenic disorders of urination are typical and common manifestation of most diseases of the nervous system. The use of urodynamic studies allows you to select up to 7 independent forms of disorders of urination, requiring an individual approach to treatment. Diagnosis of neurogenic disorders of urination is based on the comparison of the results of clinical (questionnaire and diary of urination) and paraclinical (neurophysiological, urodynamic, and neuroimaging methods and analysis of results of treatment that allows the obtained data to assess the severity of neurological disease and to forecast its further development.


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