Impact of Neurogenic Lower Urinary Tract Dysfunction on Bowel Symptoms

Purpose of reviewIn this review, the current literature available to patients and providers regarding neurogenic bowel dysfunction as it relates to the treatment of neurogenic bladder dysfunction will be addressed. Topics include the common pathophysiologic pathways, and the management of fecal incontinence and constipation that can occur simultaneously with urinary incontinence or retention, or which may result from the treatment of urinary incontinence or retention.Recent findingsThe availability of newer pharmacotherapeutics, and the adoption of chemodenervation, nerve stimulation and neuromodulation has added to the armamentarium that providers have for treating this difficult clinical constellation. And while there have not been dramatic advances in the surgical management of neurogenic bladder, our understanding of the side effects of surgery continues to evolve.Until there is a cure for traumatic and other acquired myelopathies, the urologist remains the specialist best suited to manage the subsequent urinary retention and incontinence. Virtually all interventions can have an effect, either ameliorative or adverse on the symptoms and management of concomitant neurogenic bowel dysfunction.