Neuro-Urology

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Patients with neurological disease including MS, Parkinsons, stroke and spinal cord injury can develop significant urological problems. This includes problems with bladder management, incontinence and recurrent urinary tract infections.

In 2025 NHS England published some guidance stating that most neuro urological conditions can be managed in all urology centres. This includes:

• Determining whether the bladder is safe or unsafe:
  • An unsafe bladder means that the patient is at risk of renal damage
  • An unsafe bladder is usually due to Detrusor Sphincter Dyssynergia (DSD) or poor compliance with elevated detrusor leak point pressures.
  • Determining whether a bladder is safe or unsafe helps the clinician to work out which treatment is best and a suitable surveillance protocol
     
• Investigating and managing the following:
  • Recurrent UTI’s or haematuria
  • LUTS and incontinence
  • Bowel dysfunction
  • Sexual dysfunction

However, there are certain complex neuro urological conditions, particularly patients with spinal injuries or spina bifida that will need more specialist urological care. Such care is usually embedded in the spinal injury centres.

View list of 12 spinal injury centres in the UK

GIRFT have produced guidance regarding the delivery of functional and reconstructive urology, and this includes neuro urology. It stipulates that provision of neurogenic bladder services should be accessible in all hospitals with urology provision.

However, specialist services comprising of two or more clinicians with a sub-speciality interest, MDT provision and supporting health care professionals should manage spinal cord injury, spina bifida and complex congenital urology.

GIRFT Improving functional reconstructive urology and urogynaecology service delivery - February 2025

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Considering this guidance BAUS have produced brief information guides to assist management of common neurological conditions seen in general urology centres.

Information sheets

Guidance resources