ABSTRACT

A thorough history and physical examination are the cornerstones of the initial evaluation of patients with neurological diseases, who are suffering from lower urinary tract symptoms. Although more exact and specific means are often necessary to pinpoint the nature of bladder dysfunction in such patients, a directed, thorough history and physical examination are essential to determine which patients require more costly and invasive testing, and which can be followed with alternative strategies. This chapter focuses on obtaining a neuro-urological history and performing a focused physical examination, to help determine what further investigations, if any, are necessary on subsequent visits. Obtaining a thorough sexual history is important, as sexual dysfunction is extremely common among men and women with neurologic conditions. A careful examination of sensation of the genitalia may provide insight into the nature of sexual dysfunction, as both hypo- and hyperasthesia has been described among patients with neurologic conditions.