18 - Neuromuscular disorders

Summary

In general, pelvic organ dysfunction in patients with neuromuscular disorders is the result of damage to the pelvic nerves or when the autonomic nerves are involved as a part of more generalized neuropathy. Diabetesmellitus is the most common cause of peripheral neuropathy worldwide. Type 1 diabetes results from autoimmune pancreatic beta cell destruction and Type 2 from insulin resistance. Bladder dysfunction is well recognized in acute idiopathic autonomic neuropathy. This condition is characterized by the acute onset of autonomic dysfunction and is thought to be due to lesions of the pre- and postganglionic sympathetic and parasympathetic fibers. Patients with autoimmune autonomic ganglionopathy present with rapid onset of severe autonomic failure, with orthostatic hypotension, gastrointestinal dysmotility, anhidrosis, bladder dysfunction, ED and sicca symptoms and may have circulating ganglionic acetylcholine receptor (AChR) antibodies. Pure autonomic failure (PAF) is a degenerative postganglionic autonomic disorder.