Understanding neurogenic urogenital dysfunction and the clinical application of the EAN/EFAS/INUS NEUROGED guidelines

Abstract

Neurogenic urogenital dysfunction encompasses various urinary and sexual issues resulting from neurological disorders, which significantly impact patients' quality of life. To address these challenges, the European Academy of Neurology (EAN), in collaboration with the European Federation of Autonomic Societies (EFAS) and the International Neuro-Urology Society (INUS), developed the NEUROGED guidelines. These guidelines aim to provide neurologists with evidence-based recommendations for managing neurogenic bladder and sexual dysfunctions. The task force comprised 37 members from 17 countries across four continents, highlighting a comprehensive and collaborative effort. The committee has established evidence-based recommendations for 11 key questions, consensus-based recommendations for eight questions, and good practice statements for 19, addressing the complexities of managing neurogenic urogenital dysfunction. This review seeks to enhance understanding of the NEUROGED guidelines through two sections. The first section examines the neuroanatomy, pathophysiology, and clinical presentation of lower urinary tract symptoms (LUTS) and sexual dysfunction (SD), establishing a basis for the guidelines. The second section explores the impact of the NEUROGED guidelines on the investigation and management of urogenital symptoms, addressing their implementation and potential barriers in clinical practice.