Developing new ways to assess neural control of pelvic organ function in spinal conditions: ICI-RS 2023.

Autor:	Webb K; Physiotherapy Department, Imperial College Healthcare Trust, St Mary's Hospital, London, UK., de Rijk MM; Department of Urology, School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.; Department of Urology, Maastricht University Medical Center, Maastricht, The Netherlands., Gajewski JB; Department of Urology, Dalhousie University, Halifax, Nova Scotia, Canada., Kanai AJ; Departments of Medicine-Renal-Electrolyte Division, and Pharmacology & Chemical Biology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA., Perrouin-Verbe MA; Department of Urology, Centre Hospitalier Universitaire de Nantes, Nantes, France., van Koeveringe G; Department of Urology, School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.; Department of Urology, Maastricht University Medical Center, Maastricht, The Netherlands., Wyndaele JJ; Faculty GGW, University of Antwerp, Antwerpen, Belgium., Drake MJ; Department of Surgery and Cancer, Imperial College, London, UK.
Jazyk:	angličtina
Zdroj:	Neurourology and urodynamics [Neurourol Urodyn] 2024 Aug; Vol. 43 (6), pp. 1431-1438. Date of Electronic Publication: 2023 Dec 04.
DOI:	10.1002/nau.25347
Abstrakt:	Objectives: Several central nervous system (CNS) centers affect muscle groups of the lower urinary tract (LUT) and anorectal tract (ART) via autonomic and somatic pathways, working in different modes (storage or expulsion). Hence spinal cord dysfunction can affect the LUT and ART by several possible mechanisms. Methods: This review reports the discussions of a workshop at the 2023 meeting of the International Consultation on Incontinence Research Society, which reviewed uncertainties and research priorities of spinal dysfunction. Results: Discussion focussed on the levator ani nerve, mechanisms underpinning sensory function and sensation, functional imaging, dyssynergia, and experimental models. The following key research questions were identified. (1) Clinically, how can we evaluate the levator ani muscle to support assessment and identify prognosis for effective treatment selection? (2) How can we reliably measure levator ani tone? (3) How can we evaluate sensory information and sensation for the LUT and the ART? (4) What is the role of functional CNS imaging in development of scientific insights and clinical evaluation? (5) What is the relationship of detrusor sphincter dyssynergia to renal failure? Conclusions: Spinal cord dysfunction can fundamentally disrupt LUT and ART function, with considerable clinical impact. The evaluation needs to reflect the full scope of potential problems, and new clinical and diagnostic approaches are needed, for prognosis and treatment. The preclinical science evaluating spinal cord function in both LUT and ART storage and elimination remains a major priority, even though it is a challenging experimental context. Without this underpinning evidence, development of new clinical evidence may be held back. (© 2023 The Authors. Neurourology and Urodynamics published by Wiley Periodicals LLC.)
Databáze:	MEDLINE
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