ABSTRACT
This chapter discusses the evaluation of patients with neurogenic lower urinary tract dysfunction (NLUTD) by urodynamics. Prior to this discussion, a working knowledge of the neurophysiology of micturition is essential. The filling cystometrogram is used to mimic the bladder’s filling and storage of urine while the pressure – volume relationship within the bladder is recorded. Impaired compliance is common in neurogenic voiding dysfunction and is potentially hazardous. Impaired compliance leads to high bladder storage pressures. Videourodynamics, or simultaneous fluoroscopic monitoring of the urinary tract during urodynamics, is the most comprehensive and accurate way of assessing NULTD. Some neurologic lesions may result in an open bladder neck at rest where other lesions do not affect the bladder neck function, but without fluoroscopy this cannot be easily determined.
