Bladder dysfunction in Indian patients with neurological disorders – An observational study

Objectives There is a paucity of literature regarding bladder symptoms in neurological disorders, especially from India. While bladder symptoms are inquired into during clinical interviews, significant importance and detailed assessment are rarely done. This study was planned to assess the spectrum of neurogenic bladder dysfunction encountered in a hospital-based setting in India. Materials and Methods This cross-sectional observational study was performed over 18 months. Patients more than 18 years old with bladder dysfunction owing to neurological disorders without obstructive pathology were included. Details regarding clinical symptoms, bladder involvement, and examination findings were gathered, and a neurogenic bladder symptom score (NBSS) questionnaire was administered. Results A total of 72 patients (mean age 48.8 ± 17.46 years) were enrolled with neurological disorders such as extra-medullary lesions of the spinal cord, demyelinating disorders, parkinsonian disorders, and dementia among others. Clinical localization of bladder to frontal level was found in 11.1%, suprapontine (34.7%), suprasacral (37.5%), sacral/infra-sacral (9.7%), and upper motor neuron bladder with shock (7.0%). NBSS provided a fairly good idea of severity in respective domains, i.e., incontinence, storage and/or voiding, and complications associated with bladder symptoms. However, this was not directed toward the initial assessment of suspected neurogenic bladder and diagnostic level of localization of bladder symptoms. In addition, some questions of NBSS are not tailored to the Indian population and habits. Conclusion This study reflects the spectrum of neurogenic bladder dysfunction in Indian patients. With limitations in the applicability of available bladder questionnaires to the Indian population, a tool aimed at evolving a diagnostic formulation of the level of bladder involvement will be beneficial, especially with the advent of tele-neurology.