Urology

Neurourology and Urodynamics

Neurourology is the study of how the nervous system affects the urinary system. The brain, spinal cord and nerves are very important to the healthy function of the bladder. Neurological diseases and disorders such as multiple sclerosis, Parkinson's disease, stroke, BPH and spinal cord injury can disrupt the lower urinary tract and result in conditions such as urinary incontinence and the inability to urinate. A number of treatments are available, including medications, catheter use, and surgical procedures. Urodynamic testing is any procedure that looks at how well the bladder, sphincters, and urethra are storing and releasing urine. Most urodynamic tests focus on the bladder’s ability to hold urine and empty steadily and completely. Urodynamic tests can also show whether the bladder is having involuntary contractions that cause urine leakage. Urodynamic tests range from simple observation to precise measurements using sophisticated instruments. For simple observation, a health care provider may record the length of time it takes a person to produce a urinary stream, note the volume of urine produced, and record the ability or inability to stop the urine flow in midstream.Urodynamic studies have become a major tool in evaluating lower urinary tract dysfunction in children. There are many subtleties in performing these studies in children in juxtaposition to adults; therefore, adaptations specific to children must be made to achieve accurate and reproducible results. Uniformity in how the studies are conducted from center to center will allow for healthier transparency and enhanced comparison of results in both clinical and research situations.