This CME Activity has expired and is no longer available for credit.
Consensus Statement on Neurogenic Detrusor Overactivity (NDO): Multiple Sclerosis and Spinal Cord Injury Improving Diagnosis, Management, and Treatment of NDO Through Integrated Care
Time to Complete
January 10, 2013
July 10, 2013
1.00 / AMA PRA Category 1 Credit(s)TM
Jointly sponsored by the Warren Alpert Medical School of Brown University and Health and Wellness Education Partners.
This activity is supported by an educational grant from Allergan, Inc.
This consensus statement on neurogenic detrusor overactivity (NDO) discusses the effect of NDO on the quality of life and overall health of patients with multiple sclerosis (MS) and spinal cord injury (SCI), identifies health care provider and patient barriers to care, describes best practices to screen for urinary dysfunction, and summarizes the panel’s recommendations for management of NDO in this patient population. Management strategies include antimuscarinic agents such as oxybutynin, onabotulinumtoxinA intradetrusor injection, sacral nerve stimulation, bladder augmentation or urinary diversion, and clean intermittent catheterization. Long-term follow-up of patients with NDO is important because changes in detrusor compliance and urodynamic patterns may occur over time.
This activity is designed for urologists, neurologists, physiatrists, and other health care professionals interested in or involved with the management of patients with multiple sclerosis or spinal cord injury who are at risk for neurogenic detrusor overactivity.
At the conclusion of this activity, participants should be able to:
Describe the effect of bladder dysfunction on health and health-related quality of life in individuals with multiple sclerosis (MS) and spinal cord injury (SCI)
Identify factors and barriers influencing optimal management of neurogenic detrusor overactivity (NDO) across specialties
Discuss the clinical aspects of NDO including its multiple etiologies, patient evaluation, varying treatment goals, and common coexisting conditions
Review current and future options for the management of NDO in patients with MS and SCI
Adopt new standards of care for multidisciplinary management of NDO in the practice setting
Conflicts of Interest Disclosure Statements
In accordance with the disclosure policy of the Warren Alpert Medical School of Brown University as well as standards set forth by the Accreditation Council for Continuing Medical Education, all individuals in a position to control the content of a CME activity are required to disclose relevant financial relationships with commercial interests (within the past 12 months). Disclosures of this activity’s faculty and planning committee have been reviewed and all identified conflicts of interest, if applicable, have been resolved.
Pamela I. Ellsworth, MD (Program Chair) Associate Professor of Surgery Division of Urology The Warren Alpert Medical School of Brown University Providence, RI
Pamela I. Ellsworth, MD, is a consultant/advisory board member for Allergan, Inc., Astellas Pharma US, Inc.; and Pfizer Inc. She is a speaker for Allergan, Inc. and Pfizer Inc.
Patricia K. Coyle, MD (Program Co-Chair) Professor and Acting Chair Department of Neurology Stony Brook University Director, Stony Brook MS Comprehensive Care Center Stony Brook, NY
Patricia K. Coyle, MD, is a consultant for Acorda Therapeutics; Avanir Pharmaceuticals, Inc.; Bayer Corporation; Biogen Idec Inc.; EMD Serono, Inc.; Novartis AG; Sanofi-Aventis U.S. LLC; and Teva Neuroscience, Inc. She has received grant/research support from Actelion Pharmaceuticals Ltd and Novartis AG.
Alberto Esquenazi, MD (Program Co-Chair) Professor and Chair Department of Physical Medicine and Rehabilitation Moss Rehab and Albert Einstein Philadelphia, PA Director, Gait & Motion Analysis Laboratory Moss Rehab Elkin Park, PA
Alberto Esquenazi, MD has received grant/research support from Allergan, Inc., and Ipsen.
Karl-Erik Andersson, MD, PhD Professor, Institute for Regenerative Medicine Wake Forest University Professor, Department of Urology Wake Forest School of Medicine Winston-Salem, NC
Karl-Erik Andersson, MD, PhD, is a consultant for Allergan, Inc.; Astellas Pharma US, Inc.; GlaxoSmithKline plc; and Pfizer Inc.
Jack S. Burks, MD Chief Medical Officer Multiple Sclerosis Association of America Cherry Hill, NJ
Jack S. Burks, MD, is a consultant and speaker for Acorda Therapeutics; Allergan, Inc.; Avanir Pharmaceuticals, Inc.; Bayer Corporation; EMD Serono, Inc.; and Novartis AG.
June Halper, NP Adult Nurse Practitioner Consortium of Multiple Sclerosis Centers Hackensack, NJ Advanced Practice Nurse Division of Neurology Department of Neuroscience Multiple Sclerosis Center University of Medicine & Dentistry of New Jersey Newark, NJ
June Halper, NP, is a consultant for Acorda Therapeutics; Questcor Pharmaceuticals, Inc.; and Teva Neuroscience, Inc. She is a speaker for non-CME programs for Acorda Therapeutics.
Victor W. Nitti, MD Professor and Vice Chairman Department of Urology Director of Female Pelvic Medicine and Reconstructive Surgery NYU Langone Medical Center New York, NY
Victor W. Nitti, MD, has received grant/research support from Allergan, Inc., and Astellas Pharma US, Inc. He is a consultant for Allergan, Inc.; Astellas Pharma US, Inc.; Medtronic, Inc., and Uroplasty, Inc.
William A. Sheremata, MD Professor of Clinical Neurology Department of Neurology Miller School of Medicine University of Miami Miami, FL
William A. Sheremata, MD, has received grant/research support from Acorda Therapeutics, Novartis AG, and Roche. He is a consultant for Acorda Therapeutics, Novartis AG, and Teva Neuroscience, Inc.
David R. Staskin, MD Associate Professor of Urology Tufts University School of Medicine Head, Female Urology and Neurourology Division of Urology Steward – St. Elizabeth’s Medical Center Boston, MA
David R. Staskin, MD, is a consultant for Allergan, Inc.; Antares Pharma; and Astellas Pharma US, Inc. He is a speaker for Allergan, Inc.; Astellas Pharma US, Inc.; and Watson Pharmaceuticals, Inc.
Paul J. Tobin, MSW President and CEO United Spinal Association, Inc. East Elmhurst, NY
Paul J. Tobin, MSW, is chief executive of the United Spinal Association, which has received grant support from Allergan, Inc.
Alan J. Wein, MD, FACS, PhD (hon) Professor and Chief Division of Urology Penn Medicine, Perelman School of Medicine Chief, Division of Urology Penn Medicine, University of Pennsylvania Health System Philadelphia, PA
Alan J. Wein, MD, FACS, PhD (Hon), has served as a consultant for Allergan, Inc.; Astellas Pharma US, Inc.; Endo Pharmaceut
Activity Staff Disclosures
The planners, reviewers, editors, staff, or other members at Health and Wellness Education Partners and the Alpert Medical School CME Office who control content have no relevant financial relationships to disclose.
AMA PRA Category 1 Credit(s)TM
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the Warren Alpert Medical School of Brown University and Health and Wellness Education Partners. The Warren Alpert Medical School is accredited by the ACCME to provide continuing medical education for physicians.
The Warren Alpert Medical School designates this enduring material for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
This enduring material is produced for educational purposes only. Content is provided by faculty who have been selected because of recognized expertise in their field. The opinions and recommendations expressed by the faculty whose input is included in this activity are their own. The use of the Warren Alpert Medical School of Brown University name implies oversight and review by the CME Office of educational content, format, design, and approach. Participants have the professional responsibility to review the complete prescribing information of specific drugs or combination of drugs including indications, contraindications, warnings, and adverse effects before administering pharmacologic therapy to patients. The Warren Alpert School of Medicine of Brown University assumes no liability for the information herein.
Corresponding Author Pamela I. Ellsworth, MD University Urological Associates 2 Dudley Street, Suite 185, Providence, RI 02908 Phone: 1-401-421-0710, ext. 1323 Fax: 1-401-421-0720 E-mail: firstname.lastname@example.org
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