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UCL Institute of Neurology

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Uro-neurology

 

Uroneurology
 

Urethral Pressure Profile traces. (A) Smooth (normal) UPP. (B) Pulsatile UPP *

Exploring the neural control of the lower urinary tract in health and disease, and researching non-surgical options for managing neurogenic bladder, bowel and sexual dysfunction

Lead:

Dr Jalesh Panicker

Research Team

Research Goals

  • To evaluate the central neural correlates of lower urinary tract function and dysfunction in neurogenic and idiopathic bladder conditions using advanced MR imaging techniques
  • To investigate novel treatments for the management of bladder problems in patients with neurological disease
  • To explore the mechanisms of action of treatments for neurogenic bladder dysfunction, such as detrusor injections of botulinum toxin and tibial nerve stimulation
  • To study bladder and sexual dysfunction across different progressive neurological disorders
  • To understand the basis for lower urinary tract dysfunction in Parkinson’s Disease, including the mechanisms responsible for nocturia
  • To explore novel treatment for the prevention of urinary tract infections in patients with neurological disease
  • To explore the interface between functional urological disorders and psychological co-morbidities
  • To identify physiological phenotypes of gut dysfunction and develop a targeted therapy

Funded Rsesearch Projects

  • Exploring Melatonin for the management of nocturia in Parkinson’s Disease. Funded by Parkinson’s UK
  • The central control of lower urinary tract functions in patients with neurogenic and idiopathic lower urinary tract dysfunction; Collaborative study with University of Zurich. Funded by Multiple Sclerosis Society, UCL-ZNZ Neurosciences Award
  • The Neurological and Urological Symptoms Study- collaboration with University of Edinburgh
  • Exploring the causes for non-surgical urinary retention
  • Exploring the role of PTNS (percutaneous tibial nerve stimulation) for the management of overactive bladder symptoms in neurological patients
Recent publications from Uroneurology

Lad M, Parkinson MH, Rai M, Pandolfo M, Bogdanova-Mihaylova P, Walsh RA, Murphy S, Emmanuel A, Panicker J, Giunti P.  Urinary, bowel and sexual symptoms in a cohort of patients with Friedreich's ataxia.  Orphanet Journal of Rare Diseases 2017; 12(1):158.  DOI: 10.1186/s13023-017-0709-y

Panicker J, Pakzad M, Fowler C. Fowler’s Syndrome: A primary disorder of urethral sphincter relaxation. The Obstetrician and Gynaecologist, online 31 October 2017

Youssef NA, Schneider MP, Mordasini L, Ineichen BV, Bachmann LM, Chartier-Kastler E, Panicker JN, Kessler TM. Cannabinoids for treating neurogenic lower urinary tract dysfunction in patients with multiple sclerosis: a systematic review and meta-analysis. BJU International 2017; 119(4):515-521doi: 10.1111/bju.13759. Epub 2017 Feb 23.

Batla A, Tayim N, Pakzad M, Panicker JN. Treatment Options for Urogenital Dysfunction in Parkinson's Disease. Curr Treat Options Neurol. 2016 Oct;18(10):45. doi: 10.1007/s11940-016-0427-0.

Phé V, Pakzad M, Haslam C, Gonzales G, Curtis C, Porter B, Chataway J, Panicker JN. Open label feasibility study evaluating D-mannose combined with home-based monitoring of suspected urinary tract infections in patients with multiple sclerosis. Neurourol Urodyn. 2017 Sep;36(7):1770-1775. doi: 10.1002/nau.23173. Epub 2016 Nov 4.

Tudor KI, Sakakibara R, Panicker JN. Neurogenic lower urinary tract dysfunction: evaluation and management. J Neurol. 2016 Dec; 263(12):2555-2564.doi:10.1007/s00415-016-8212-2

Further information

* Sihra N, Malde S, Panicker J et al.  Does the appearance of the urethral pressure profile trace correlate with the sphincter EMG findings in women with voiding dysfunction?  Neurourology and Urodynamics, online 5 July 2017, 10.1002/nau.23341