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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