Sexual Dysfunction and Fertility in Neurogenic Lower Urinary Tract Dysfunction

In the 90s a better understanding of the pathophysiology of erectile dysfunction (ED) was formulating [1]. Simultaneously the magnitude and the correlates of male sexual dysfunction were getting in focus [2]. A few years later, oral phosphodiesterase type 5 inhibitors (PDE5i) came to use and along came the development of several objective assessment tools to gauge sexual dysfunction in men [3]. Parallel to these developments, lower urinary tract symptoms (LUTS) were under extensive investigations which resulted in a major shift in diagnosis and treatment. Not before long that the association of LUTS and male sexual dysfunction was clear [4]. Therapies that targeted both were tried [5, 6]. The female sexual dysfunction (FSD) finally reached focus and went along the path of development of objective assessment tools, identifying risk factors and looking at treatment options [7]. The association between a neurologic pathology and each facet of the genitourinary dysfunction is rampant in the literature, albite on a paired basis. The association between a neurologic pathology and either ED, orgasm, ejaculatory dysfunction, LUTS, fertility or FSD was repeatedly reported (Fig. 56.1). On the other hand, the association of LUTS on one hand and either male or female sexual dysfunction was a subject of many reports. There is a paucity of reporting of the association of the three conditions together whether in men or women. The purpose of this review is to shed light on citations that had a clear view of the presence of such association and how it was managed.