On the basis of previous classification of lower urinary dysfunction, the author developed a new classification of the comprehensive urinary tract dysfunction for neurogenic bladder, which included a new grading standard for the hydronephrosis and ureter dilatation. This classification can provide with comprehensive, scientific and objective basis for the evaluation, description and recording the pathphysical changes of lower and upper urinary tract dysfunction.

Under the new mode of training clinical post-graduate students, it is enhanced to train the clinical competence in rehabilita-tion medicine. As high level professionals, the scientific research ability is very important for the post-graduate students, too.

Injection of botulinum toxin type A (BTX-A) seems to have a positive therapeutic effect in multiple urological conditions, including detrusor external sphincter dyssynergia, voiding dysfunction, painful pelvic floor, bladder overactivity, frequency-urgency syndrome, interstitial cystitis, benign prostatic hyperplasia, and be thought as a novel and promising treatment for a variety of lower urinary tract dysfunctions within the urological field. However, there is a long way to go to assess the clinical efficacy of this form by randomized, double blinded, placebo-controlled trials.

ObjectiveTo evaluate the efficacy and tolerance of tolterodine in treating detrusor hyperreflexia in patients with spinal cord injury.Methods50 patients of spinal cord injury patients with detrusor hyperreflexia were involved in this study.The data from voiding diary were evaluated 7 days before and after the patients being treated with tolterodine 2 mg twice daily.ResultsAfter 12 weeks of treatment,the functional bladder volume increased from(114.0±44.3) ml to(207.7±54.9) ml,the mean frequency of micturition decreased from(8.9±2.7) /d to(4.6±2.5) /d,the mean volume of incontinence decreased from(646.7±348.9) ml to(426.6±291.3) ml,the mean frequency of incontinence decreased from(7.8±3.1) /d to(4.8±3.2) /d,which were all statistically different before and after treatment.5 patients felt dry mouth,but they could tolerated it.ConclusionTolterodine is an effective and well tolerable antimuscarinic agent for treating detrusor hyperreflexia after spinal cord injury.

Parkinson disease (PD) is one of the common neurological conditions with chronically progressed dyskinesis. 35%～70% of them are perplexed by micturition disorder, which frequently occurs in advanced stage. Urodynamics shows detrusor's overactivity and reflexic incontinence complete voiding. Treament at present includes mainly anticholinergic agents, infusing agents in bladder and/or Botulinum toxin multipoint injections to detrusor. Its genesis and effect is related to deterioration of dopaminergic neurons, hovever, and the mechanism is needed to be elucidated.

Micturition is a complicated physiological activity and is controlled by many central pathways. With the application of positron emission tomography (PET), single photon emission computed tomography (SPECT) and functional magnetic resonance imaging (fMRI), people can observe the activity of the brain during the course of micturition and urinary continence. This paper will review the physiological micturition and central pathways controlling for micturition.

Voiding dysfunction is a common lower urinary tract disorder, including urgency incontinence, urgency frequency, urinary retention and so on. Sacral neuromodilation is adapt for the patients who are fail for the conservative treatments and are intend to have operation. This paper would review some of this new method, such as the history, mechanism, indication, technical procedure and curative effect.

The feasibility and mechanism study on intravenously injected bone marrow mesenchymal stem cells (MSCs) improving bladder function after spinal cord injury (SCI) were discussed by review the biological characteristics of MSCs, the changes and mechanism of the lower urinary tracts after SCI, and the study on the MSCs promoting recovery of bladder function.

The artificial urinary sphincter (AUS) has been used for the treatment of various incontinence due to intrinsic sphincter deficiency, and is considered as the gold standard treatment for incontinence after a prostatectomy. The long-term satisfaction rates exceed 80%, but almost a third of patients with AUS require revision surgery within 5 years. This paper reviewed the common complications of AUS implantation and the treatment.

Interstitial cystitis (IC) is a chronic condition characterized by pain of the bladder and pelvic region, urgent micturition, frequent micturition and urine increased. Despite intense investigation to our knowledge, the etiology of this disease was unknown, and treatment is empirical. Recrudesce of IC was inextricable and hard to radical cure. This paper reviewed the literature published in the last years.