title: Lower urinary tract and sexual dysfunction in neurological patients.
abstract: BACKGROUND
  Lower urinary tract dysfunction (LUTD) and sexual dysfunction (SD) are common in neurological patients due to a combination of lesions affecting relevant neural control, constraints imposed by sensorimotor and cognitive deficits and--particularly for SD--psychosocial consequences of chronic neurological disease.
  
  
  CONCLUSIONS
  This review summarizes the etiology, diagnosis and treatment of LUTD and SD in neurological patients.
  
  
  CONCLUSIONS
  LUTD may lead to serious health problems; both LUTD and SD significantly affect quality of life. Management of patients with spinal cord injury and dysraphism is undertaken in specialized centers according to established guidelines. Treatment of neurological patients with noncomplicated neurogenic LUTD or SD should preferentially be guided by a neurologist.
  
  
  CONCLUSIONS
  For rational treatment of urinary symptoms, an accurate assessment is mandatory; the bladder and the sphincter need to be defined as normal, over- or underactive. Urodynamic testing is the gold standard for functional diagnosis; assessment of residual urine and uroflow are the minimal requirements before considering management. Dysfunction of desire, arousal and orgasm (ejaculation) may be diagnosed by medical history and are amenable to counselling and treatment, which is--in the case of erectile dysfunction--evidence based. Further high-quality studies are necessary to test the best approaches for diagnosing and managing particular types of neurogenic LUTD and SD in the different neurological patient populations.
authors.affiliation: Division of Neurology, University Medical Centre and Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.
authors.forename: David B
authors.initials: DB
authors.lastname: Vodušek
mesh_terms: D000818:Animals; D002908:Chronic Disease; D006801:Humans; D009422:Nervous System Diseases / Q000150:complications* / Q000503:physiopathology; D012735:Sexual Dysfunction, Physiological / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D014570:Urologic Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*