Screening tools to identify a neurogenic cause for pelvic organ dysfunction: a scoping review

Abstract

Background Pelvic organ dysfunction can be an early sign of neurological disease, potentially preceding recognition of the underlying neurogenic mechanism. Screening tools are widely used in healthcare to aid early detection. Many tools exist for assessing pelvic organ symptoms, but it is unclear if any are designed to identify whether neurological disease is causing pelvic organ symptoms, nor whether there may be a potential neurogenic basis for such symptoms in the absence of prior neurological diagnosis. Objective To identify assessment and diagnostic tools used to evaluate pelvic organ symptoms in neurological disease and determine their intended purposes, including whether any are designed to evaluate likelihood of neurogenic basis. Methods A scoping review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) scoping review guidance. Searches of MEDLINE, CINAHL, and Embase databases included terms such as “assessment and screening tools,” “neurological conditions,” and “pelvic organ dysfunction.” Results From 1600 papers screened, 513 were included. Across these, 212 different tools were identified, covering a wide variety of uses. However, none were specifically developed to screen for a neurogenic cause of pelvic organ symptoms in patients with or without a prior neurological diagnosis. Conclusions There are currently no tools designed to establish neurogenic mechanisms underlying pelvic organ symptoms. For undiagnosed individuals, this type of tool would trigger prompt neurology review, potentially improving prognosis. Developing a screening tool focused on detecting neurogenic origins could support earlier recognition and management of many neurological conditions associated with pelvic organ dysfunction