New guideline on neurogenic bladder disorders published in Germany

The German Society for Neurology (DGN) has published a new version of the S1 guideline "Diagnostics and therapy of neurogenic bladder disorders." It is valid until January 2025.

The authors recommend the following diagnostic cascade:

• Anamnesis
• Neurological and urological examination, if necessary, gynecological examination
• Bladder diary for at least three full days
• Urine sediment examination (medium jet or better catheter urine)
• Residual urine measurement (sonographically or by single-use catheterization)
• Urine flow measurement (Uroflow)
• (Video) urodynamics (so-called bladder pressure measurement) with pelvic floor electromyography (EMG)
• Urethrocystoscopy and urinary bladder cytology
• Kidney sonography
• Creatinine, urea, possibly 24-hour creatinine clearance
• Lasix or stress isotope nephrogram.

If vesicorenal reflux has already occurred, it is advisable to use these procedures to document the initial findings. Based on these steps, a diagnosis can usually be made. Differential diagnosis should also distinguish psychiatric and psychosomatic diseases.

The guideline in German can be found here.

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