Management of lower urinary tract dysfunction in neurological disease- new NICE guidelines

NICE have issued new guidelines for the management of lower urinary tract dysfunction in neurological disease. These are available at the NICE website. The guidelines include taking a history, assessing the impact of problems and screening for urinary tract infection and renal insufficiency. Urgent referral for a specialist opinion is required if there is:
1) haematuria
2) recurrent urinary infection (3 or more in 6 months)
3) loin pain
4) progressive renal insufficiency or hydronephrosis on ultrasound.
6) frequent blocking of urinary catheters (more frequent than every 6 weeks)
The guidelines then discuss specialist investigations, including video urodynamics, treatment and longterm monitoring, including lifelong annual or biannual ultrasound monitoring of the renal tract in those at risk of hydronephrosis (these include people with spinal cord injury, spina bifida, or adverse features on urodynamic investigations such as impaired bladder compliance, detrusor-sphincter dyssynergia, or vesicoureteric reflux).