Neuro-Urology has become a well-established and highly recognized sub-speciality in the fields of Neurology and Urology. Neurogenic urinary tract dysfunction is common all over the world and affects the lives of millions of people. It has a major impact on quality of life and sexuality and besides the debilitating manifestations for patients it also imposes a substantial economic burden on every health care system.
The control of the urinary tract is a complex, multilevel process that involves the peripheral and central nervous system. Thus, patients with neurological diseases often suffer from urinary tract dysfunction with a prevalence that may approach 100% (for instance in patients with multiple sclerosis), depending on the type and duration of the neurological disease in cases where neurogenic urinary tract dysfunction is not recognized or inadequately managed, it may result in life-threatening complications such as recurrent urinary tract infections, vesico-uretero-renal reflux, hydronephrosis, and renal failure. Indeed, in the past renal disease was responsible for more than 40% of deaths following spinal cord injury.
Modern Neuro-Urology, including the introduction of intermittent self-catheterization and the use of regular urodynamic investigations, has since revolutionized the neuro-urological care of SCI patients. Hence, nowadays, urinary disease accounts for only about 13% of deaths in SCI patients whereas pneumonia, influenza, non-urinary tract septicaemia, cancer, and ischemic heart disease are more common causes of death. Neuro-urological care aims to enhance quality of life, preservation or improvement of upper urinary tract function, control of urinary tract infection, and to achieve urinary continence.
Evaluation of new approaches in the treatment and neurophysiological assessment of healthy and impaired human lower urinary tract function
The measurement of sensory evoked potentials elicited by electrical stimulation at different locations of the lower urinary tract has the potential to serve as a neurophysiological biomarker for lower urinary tract afferent nerve function in patients with lower urinary tract symptoms. For implementation of such a diagnostic tool into clinical practice, an optimized setup with efficient and reliable measurements and data acquisition is crucial.