The evaluation of the social disadaptation and depression severity in patients with neurogenic urinary bladder dysfunction before and after botulinum toxin therapy

Anxiety, depression and other psychological problems occur often as complications of somatic diseases, including the neurogenic dysfunction of the urinary bladder (NDUB), which appears as the urgency, often together with the urgent urinary incontinence (UUI). Lower urinary tract dysfunction, related to the neurological diseases/neural damage (neurological infections, spinal disorders, trauma, cerebrovascular problems, etc.) is one of the frequent reasons for the consultation by neurourologist. The aim of our study was to evaluate the changes in the psychological and emotional state of the patients, which were treated using the injection of the botulinum toxin (BT) in the urinary bladder due to NDUB and urgency. Fifty-four patients with urodynamically confirmed NDUB were included in the study. All patients were evaluated two month before and two month after the treatment, including the bladder diary, urodynamics, neuropsychological testing and consultation by neurologist. NDUB in form of urgency with or without UUI presents with the prominent urodynamic disturbances and decrease in the life quality, psychoemotional problems and depression. BT injection in the bladder wall is the effective method of detrusor overactivity correction, which could improve not only the urodynamical parameters, but also the severity of the anxiety and depression.