About This Site

This module is the result of more than 35 years experience in the care of patients with neurogenic vesical dysfunction related to spinal cord injury, multiple sclerosis, and myelodysplasia. There are aspects of the care of these patients which are quite unique to this population and as such are unknown to most medical professionals. In the past care of patients with spinal cord injury occurred almost exclusively in specialized centers. This leads to isolation of patients with neurological problem from mainstream medicine with both good and bad effects. Care was directed and specialized in such centers but remained isolated so that the principle of that care, which were developed over a relatively short period of time remain rather unknown to the general medical community with predictable results. Patients and conditions depicted in this module are drawn from a busy neurourology practice with the full knowledge and consent of the subjects who understand this is an educational endeavor.

Target Population
Any medical professionals involved in the care of SCI/MS diseases, including

  • Medical Students
  • Urology Nurses
  • Training Urology Residents
  • General Urology Physicians
  • Rehabilitation Medicine Physicians
  • Primary Care Physicians in the community 

Purpose

  • To understand the basic anatomy, physiology, pharmacology of the lower urinary tract
  • To understand the natural history and pathophysiology of the SCI neurogenic bladder.
  • To understand the symptoms and management of autonomic dysreflexia
  • To understand potential long-term complications of the SCI/D
  • To understand risk factors of the SCI/D to the kidney and the significance of increased intravesical pressure
  • To understand basic information on urodynamic procedures
  • To understand the significance of urodynamic study in diagnosis
  • To understand the role of video urodynamic studies
  • To understand mechanism of action and side effects of medical therapy for bladder dysfunction, including anticholinergic agents smooth muscle agents and alpha blocking agents.
  • To understand surgical management options for the SCI neurogenic bladder
  • To understand the need for long-term urologic surveillance
  • To understand the importance of CIC in the management of the SCI patients
  • To understand why indwelling catheter management should be avoided
  • To understand the clinical significance of UTI in SCI neurogenic bladder

Features

  • The content was intended to include rich descriptions and actual case material, not idealized, but factual and honest
  • We tried to provide unbiased, universally accepted, contemporary knowledge by reviewing recent and vast literature.
  • We tried to keep to evidence-based content. References for each content area were reviewed and we selected the most representative studies. To gain further knowledge, we suggest that the student, for whom this material is intended and for his or her patients, can read these references.  
  • We tried to summarize the key points of each content section in the box located at the last part of the content. These key points are broad but essential to all medical professionals. 
  • The content was set at the level of urology residents at the University of Michigan but the content is broadly based and copiously illustrated with actual case material, rather than in the traditional book chapters variety. This material is quite contemporary the cases are drawn from 2004 and 2005.
  • To provide better understanding of the concept, we developed image-driven content consisting of large amount of video clips and still images.
  • Related contents are interlinked so that the audience can start from any content in this module. 
  • This module is primarily focused on the basic science, diagnosis, and management of SCI patents. The contents on multiple sclerosis are included in a supplement.  

Restriction of This Information

  • The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
  • A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions.
  • Any duplication or distribution of the information contained herein is strictly prohibited.
  • In some parts of the educational videos, the clips contain images of the genital area and medical procedures including graphic images. Please proceed at your discretion.

Development Team

PROGRAM DIRECTOR

Edward J. McGuire, MD

CO-INVESTIGATOR

Seung June Oh, MD

KEY PERSONNEL

John T. Stoffel, MD

Jerilyn M. Latini, MD

Deborah A. Crider, RN, MS

4. CONSULTANTS

David R. Gater, Jr., MD, Ph.D.

William M. Scelza, MD

Ronald S. Suh, MD

Christine Brown, RN

Gary A. Wedemeyer

©2007 University of Michigan

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