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Alsulihem et al. Neuroimmunol Neuroinflammation 2019;6:13 Neuroimmunology
DOI: 10.20517/2347-8659.2019.007 and Neuroinflammation

Review Open Access

Evaluation, treatment, and surveillance of
neurogenic detrusor overactivity in spinal cord

injury patients

Ali Alsulihem , Jacques Corcos 1
1,2
1 Department of Urology, Jewish General Hospital, McGill University, 3755 Côte-Sainte-Catherine Road, Pavillion E. Montreal,
QC, H3G 0C7, Canada
2 Department of Urology, Prince Sultan Military Medical City, P.O. Box 7897, Riyadh 11159, Saudi Arabia.

Correspondence to: Prof. Jacques Corcos, Department of Urology, Jewish General Hospital, McGill University, 3755 Côte-
Sainte-Catherine Road, Pavillion E. Montreal, QC, H3G 0C7, Canada. Email: jcorcos@jgh.mcgill.ca

How to cite this article: Alsulihem A, Corcos J. Evaluation, treatment, and surveillance of neurogenic detrusor overactivity in
spinal cord injury patients. Neuroimmunol Neuroinflammation 2019;6:13. http://dx.doi.org/10.20517/2347-8659.2019.007

Received: 1 Aug 2019 First Decision: 23 Sep 2019 Revised: 28 Oct 2019 Accepted: 30 Oct 2019 Published: 8 Nov 2019
Science Editor: Swapan K. Ray Copy Editor: Jing-Wen Zhang Production Editor: Tian Zhang

Abstract
Neurogenic detrusor overactivity is a common urodynamic finding in patients with supra-sacral spinal cord injury. Early
evaluation, stepped management, and close follow-up reduce the risk of upper urinary tract deterioration, renal failure
and incontinence. In this article, we aim to outline the modern pathway of the management of this complex disease.
Evaluation of patients with history, physical examination, renal function assessment, cystoscopy, and urodynamic study
are essential. Management of neurogenic detrusor overactivity with adequate bladder drainage, medical therapy, intra-
detrusor botulinum injections, and surgery can be offered in a stepwise manner. Follow-up after specific interventions
should be done in a timely fashion to detect treatment response and to avoid complications of poorly managed
neurogenic detrusor overactivity.

Keywords: Spinal cord injury, neurogenic lower urinary tract dysfunction, neurogenic bladder, neurogenic derusor
overactivity, evalutation, treatment, surveillance

INTRODUCTION
Spinal cord injury (SCI) is one of the most common causes of neurogenic lower urinary tract dysfunction,
which affects more than 291,000 individuals in the United States and an annual incidence rate of 17,730
[1]
[2]
cases . It is estimated that 70%-84% of SCI patients have neurogenic lower urinary tract dysfunction .

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
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