Uro-Neurology

The department of uro-neurology uniquely bridges the disciplines of neurology, urology, uro-gynaecology, neurogastroenterology, pelvic neurology/neurophysiology, psychology and pelvic physiotherapy, and offers a holistic, multidisciplinary approach to the evaluation and treatment of bladder, bowel and sexual dysfunction in individuals with established and suspected neurological disorders.

The team consists of consultants, nurses, clinical scientists performing urodynamics and neurophysiology, junior doctors, a psychologist and pelvic floor physiotherapist.

The department sees individuals  across a wide range of  neurological disorders that include multiple sclerosis and related inflammatory disorders, dementias, Parkinson’s Disease and Parkinson's plus syndromes, spinal cord and brain tumours  and traumatic disorders such as cauda equina injury. Bladder problems  such as urinary incontinence and urinary retention are common in these conditions and the service offers a comprehensive urological assessment that includes urodynamics testing.

The department  offers a holistic approach to the evaluation  and treatment of urinary retention in young women, many of whom are eventually found to have a primary disorder of urethral sphincter relaxation (sometimes called Fowler’s syndrome).

A growing number of individuals with unexplained bladder, sexual, bowel and pelvic floor dysfunction  are being referred for evaluating a possible neurological cause, and the department offers a dedicated pelvic neurology service that  includes pelvic neurological examination, pelvic neurophysiology testing evaluating the afferent and efferent sacral somatic innervation and urodynamics testing, and has links with neuroradiology.

Different treatments for managing bladder problems, ranging from conservative measures including pelvic floor physiotherapy and catheterization to tibial nerve stimulation (percutaneous and transcutaneous; PTNS and TTNS), botulinum toxin (Botox) into the bladder (detrusor) and urethral sphincter and sacral neuromodulation, are offered by the service.

Bowel dysfunction is common following neurological disorders and  the department offers a dedicated neurogastroenterology service.

The department also runs a dedicated clinic for women reporting sexual difficulties following neurological disease.

Uro-neurology has close links with allied services within UCLH such as functional urology, gynaecology, andrology, gastroenterology and the GI physiology unit for testing, autonomics and pain management.

The department has a strong academic component and is heavily involved in teaching and training of doctors, nurses and other health care professionals. Through its links with UCL and the UCLH/UCL NIHR Biomedical Research Centre, the department is involved in clinical trials and  original research exploring the neural control of bladder functions, urogenital dysfunction following neurological disease and non-surgical management options.