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Assessing bladder, bowel and sexual symptoms: a neurologist's guide
Tamara B Kaplan1,2, Jessica Zhang3, Liam G McCoy4,5,6
1Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA tbkaplan@bwh.harvard.edu.
Practical Neurology
|December 3, 2025
Summary
Neurological diseases often cause bladder, bowel, and sexual dysfunction, impacting patient quality of life. This review offers neurologists a structured, evidence-based approach to assessing and treating these common, yet often overlooked, symptoms.
Area of Science:
- Neurology
- Urology
- Gastroenterology
- Sexual Health
Background:
- Bladder, bowel, and sexual dysfunction are prevalent in neurological disorders.
- These dysfunctions significantly increase patient morbidity and decrease quality of life.
- They are frequently under-recognized and undertreated compared to other neurological issues.
Purpose of the Study:
- To present a structured, evidence-based framework for neurologists.
- To guide the evaluation of bladder, bowel, and sexual dysfunction in neurological patients.
- To improve the recognition and management of these common symptoms.
Main Methods:
- Systematic literature review.
- Evidence synthesis.
- Clinical guideline development.
Main Results:
- A structured approach involving detailed history taking is crucial.
- Comprehensive neurological examination aids in diagnosis.
- Judicious use of investigations is recommended for accurate assessment.
Conclusions:
- Effective management requires a systematic evaluation process.
- Addressing bladder, bowel, and sexual dysfunction is essential for holistic neurological care.
- This review provides a practical guide for clinicians treating neurological patients.
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