Management of Chronic Bacteriuria in Neurogenic Bladders

Lower urinary tract dysfunction is a major cause of morbidity in patients with neurogenic conditions. One of the significant issues in this group is urinary tract infections. In this review, the causes of bacteriuria along with the symptoms, diagnosis, prevention and treatment options will be discussed. As in other areas of neuro-urology there is a lack of randomized controlled trials in this field. Most of the evidence is from retrospective cohort studies. Nonetheless, there are a number of guidelines and consensus statements from international organizations to standardize the treatment of recurrent urinary infections in this complex group of patients. The management of recurrent urinary infections symptoms in neurogenic patients is challenging as these patients do not always exhibit classical signs and symptoms. The evidence base is not so strong for treatment pathways. We need structured randomized control studies to better understand and manage this complex condition in this cohort of patients.