After all these years of practice with patients presenting urinary tract symptoms secondary to many neurological diseases, we boil them down into three categories. The first group is recent spinal cord injured individuals that we see for the first time. Almost independently of the gravity of their lesion the same approach in terms of history taking and investigation plan is used. It is relatively rare to start investigating and treating their condition on this first visit except for assuring a proper bladder emptying technique .

The second group of patients is the vast majority of neurologically impaired individuals, with usually well-diagnosed neurological disease (multiple sclerosis, Parkinson disease, stroke, myelomeningocele, spinal cord injury, etc.) that we see for lower urinary tract symptoms. They have symptoms due to detrusor or sphincteric hypo or over activity. For this second group of patients diagnosis of precise dysfunction and treatment are immediately initiated.

Finally, the third group of patients are those previously diagnosed with neurological diseases and frequently initially well treated neurogenic bladder dysfunctions but who were lost to follow-up and present with a urinary complication: infection, stone, hydronephrosis with or without renal function impairment or more rarely urinary tract cancers. This last group of patients needs urgent changes in the management of their neurogenic bladder and urgent specific diagnostic and treatment approach for the complication which brought them to us.

At the end of each chapter, readers will be provided with summary and recommendations. Whereas the summary part will be supported by levels of evidence (LE) , the recommendation part will be enriched by grades of recommendation (GR) . In supporting day-to-day clinical practice, it is highly desirable that the recommendations should follow an accepted grading system for evidence and recommendation. Thus, we decided to utilize a modified version of the Oxford System for Evidence Based Medicine as this system has already been used by the leading urological societies and consensus documents, for instance the European Association of Urology (EAU) , Canadian Urological Association (CUA) , or International Consultation on Incontinence (ICI) . The modified version of the Oxford system can be directly “mapped” onto the original Oxford system and it is more applicable for daily practice of clinicians [1]. The employed system is presented in Table 1.1.