2012-NICE神经系统疾病所致的尿失禁的治疗.pdf

Urinary incontinence in neurological disease Management of lower urinary tract dysfunction in neurological disease Issued: August 2012 NICE clinical guideline 148 .uk/cg148 NHS Evidence has accredited the process used by the Centre for Clinical Practice at NICE to produce guidelines. Accreditation is valid for 5 years from September 2009 and applies to guidelines produced since April 2007 using the processes described in NICEs The guidelines manual (2007, updated 2009). More information on accreditation can be viewed at www.evidence.nhs.uk © NICE 2012 Urinary incontinence in neurological disease NICE clinical guideline 148 Contents Introduction 3 Patient-centred care6 Key priorities for implementation7 1 Guidance 10 1.1 Assessment of lower urinary tract dysfunction in patients with neurological conditions 10 1.2 Information and support 13 1.3 Treatment to improve bladder storage 14 1.4 Treatment for stress incontinence 17 1.5 Treatment to improve bladder emptying 18 1.6 Management with catheter valves 18 1.7 Management with ileal conduit diversion 19 1.8 Treatment to prevent urinary tract infection 19 1.9 Monitoring and surveillance protocols 20 1.10 Potential complications: providing information and initial management 21 1.11 Access to and interaction with services 22 2 Notes on the scope of the guidance 24 3 Implementation24 4 Research recommendations24 4.1 Safety and efficacy of antimuscarinics 24 4.2 Safety and efficacy of botulinum toxin 25 4.3 Management strategies to reduce the risk of symptomatic urinary tract infections ..26 4.4 Bladder management strategies 2