ABSTRACT
The American Urological Association/Society of Urodynamics Female Pelvic Medicine and Urogenital Reconstruction Adult Urodynamics Guideline was published with the intent of guiding the clinician in the role of urodynamics in the evaluation and management of complex lower urinary tract conditions. This article examines each guideline statement and attempts to provide clinical context for each statement. Key points are emphasized in the form of clinical case scenarios, which demonstrate application of the principles stressed in this guideline. It is hoped the reader will have a better clinical frame of reference relative to each statement in these guidelines.
Subject(s)
Pelvic Organ Prolapse/diagnosis , Urinary Bladder Diseases/diagnosis , Urinary Incontinence, Stress/diagnosis , Electromyography , Fluoroscopy , Humans , Pelvic Organ Prolapse/physiopathology , Urinary Bladder, Neurogenic/diagnosis , Urinary Bladder, Neurogenic/physiopathology , Urinary Bladder, Overactive/complications , Urinary Bladder, Overactive/diagnosis , Urinary Bladder, Overactive/physiopathology , Urinary Catheterization , Urinary Incontinence, Stress/etiology , Urinary Incontinence, Stress/physiopathology , UrodynamicsABSTRACT
BACKGROUND/OBJECTIVE: Patients with neurogenic bladder secondary to spinal cord injury who are managed long term with an indwelling catheter are known to be at increased risk for transitional cell carcinoma of the bladder. Immunosuppression is a known risk factor for malignancies that often are more aggresSive than those seen in normal populations. METHOD: Case report and discussion of management recommendations. RESULTS: We summarize the case of a 44-year-old HIV-positive C5-C6 incomplete tetraplegic male (date of injury 1980), who was diagnosed with transitional cell carcinoma of the bladder and succumbed to disease within 6 months of diagnosis. The patient was a non-smoker who was never managed with an indwelling catheter. There has been no such case reported in the literature. CONCLUSIONS: HIV infection in the presence of a neurogenic bladder may carry an increased risk of aggressive bladder malignancy. More studies are warranted to determine whether routine annual screening with cystoscopy in all patients with HIV and neurogenic bladder is indicated.