Managing Sphincter Deficiency Stress Urinary Incontinence in the Neurogenic Patient: Diagnosis and Management Strategies

Purpose of Review In this review, we present the current literature on the diagnosis and management of stress urinary incontinence induced by sphincter deficiency associated with neurogenic lower urinary tract dysfunction. Recent Findings Because sphincter deficiency stress urinary incontinence is not a common condition, there are no guidelines or large-scale clinical studies that focus on the diagnosis and management of this condition. Although there is consensus that urodynamic investigation is the only method to assess the function of the lower urinary tract, there is no established urodynamic criteria to diagnose neurogenic sphincter deficiency. As for the treatment of sphincter deficiency stress urinary incontinence in neurogenic patients, artificial urinary sphincter has a better success rate and a higher complication and reoperation rate than other methods including sling surgery and injection of bulking agents. Summary Although there is a progress in the evaluation and management of neurogenic patients with sphincter deficiency stress urinary incontinence, a prospective multicenter clinical study on this condition should be highly recommended.