Predicting Upper Urinary Tract Risk in the Neurogenic Bladder Patient
Kovacevic N, Lopes NN, Raffee S, and Atiemo HO. Predicting Upper Urinary Tract Risk in the Neurogenic Bladder Patient. Current Bladder Dysfunction Reports 2020.
Current Bladder Dysfunction Reports
Purpose of Review: In this review, we explore if risk factors for developing renal deterioration can be identified in a timely fashion, thereby preventing or delaying the progression of renal injury in the neurogenic bladder patient. Recent Findings: Historically detrusor leak point pressure (DLPP) > 40 cm H2O has been used to identify risk of upper urinary tract dysfunction (UUTD). Recent studies suggest that DLPP should not be the only decision-making parameter to predict the risk of UUTD and that patients with DLPP > 20 cm H2O should be followed closely for upper tract assessment. Furthermore, a variety of urinary biomarkers can be used markers of UUTD to guide management of neurogenic patients. Summary: Urodynamic studies represent a valuable tool in the evaluation and monitoring of urinary tract function. Multiple sources have emphasized the early identification and regular follow-up of these patients to not only have a baseline urinary tract function but also to monitor renal function and evaluate for upper tract damage.
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