Urodynamic Findings that Are Most Impactful for Patients with Neurogenic Bladder and the Literature that Supports This

Purpose of Review: To identify urodynamic risk factors that are most impactful in patients with neurogenic bladder (NGB) and review the recent literature on this, and summarize the historic evidence for those risk factors. Recent Findings: A systematic English language literature review was done between August 2018 and August 2023 to identify urodynamic risk factors for urologic complications in patients with NGB. A scoring method was developed and assessed to evaluate the quality of scientific literature concerning urodynamic risk factors. Ten studies met the inclusion criteria, of which 80% were retrospective. Eight of 10 studies found that high detrusor leak point pressure (DLPP) and/or low bladder compliance (LBC) were risk factors for upper tract deterioration. One study found no correlation between urodynamic risk factor and urologic complication. Urologic complications studied were upper urinary tract deterioration (UUTD), recurrent or febrile UTI, and need for surgery. The quality metrics complication score ranged from 7 to 20 (out of 39) across the ten articles included in this study. Summary: The maintenance of low bladder pressure continues to be the mainstay of preventing UUTD in NGB. The widely accepted urodynamic risk factors that predict urologic complications in NGB patients have poor contemporary documentation in the recent literature. Notwithstanding, we believe DLPP, low bladder compliance, and detrusor external sphincter dyssynergia continue to be major risk factors for the development of urologic complication.