Clinical features and prognosis of ‘scan negative’ uro-neurological disorders

Uro-neurological disorders are those in which there is a disturbance of bladder function related to a neurological cause. However, many patients with a combination of urological and neurological symptoms, such as bladder voiding dysfunction and leg weakness or numbness, are not found to have explanatory abnormalities despite adequate clinical and radiological investigation, so-called ‘scan negative’ patients. In this PhD patients with ‘scan negative’ uro-neurological diagnoses were primarily investigated through studies of patients presenting with suspected Cauda Equina Syndrome and to a lesser extent Chronic Urinary Retention (including Fowler’s syndrome). The PhD goal was to deeply phenotype patients with ‘scan negative’ Uro- neurological disorders and in so doing, to improve our scientific understanding of these presentations and inform the development of clinical trials. The PhD explores the historical literature linking patients with idiopathic urological dysfunction and functional disorders, reviews the incidence, research and definitions of cauda equina syndrome and phenotypes patients in a retrospective and prospective manner who present with acute scan negative urological dysfunction (‘scan negative’ cauda equina syndrome) as well as investigates for evidence of functional disorders in chronic scan negative urological dysfunction (Fowler’s syndrome) and evidence of urological dysfunction in patients with functional disorders and neurological dysfunction