Other (Bladder Cancer, Sexual Dysfunction)

Bladder cancer is a significant oncologic complication in patients suffering from neurogenic lower urinary tract dysfunction. Available data suggest that bladder cancer occurs more often in neurogenic individuals than in the general population. It is also associated with significant mortality. Several risk factors have been identified, but the proposed screening strategies still remain a matter of dispute because available screening tests do not fulfill multiple criteria of a proper screening test. The potential morbidity, financial burden, and lack of proven benefit discourage currently available screening strategies in this specific population. Neurogenic individuals continue to have active sexual lives and to consider sexuality as one of their priorities. Sexual dysfunction is highly prevalent and adversely affects the quality of life of neurogenic patients. Neurogenic sexual dysfunction remains difficult to diagnose and treat effectively. Neurogenic patients, regardless of sex, should be specifically queried about sexual function. In males, treatment includes oral and local pharmacotherapy, mechanical (vacuum constriction) devices, and prosthetics. Treatment of sexual dysfunction in neurologically impaired women is rather limited and poorly studied.