{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T23:48:27Z","timestamp":1791416907228,"version":"4.3.3"},"reference-count":112,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T00:00:00Z","timestamp":1744243200000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100011963","name":"European Academy of Neurology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011963","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011963","name":"European Academy of Neurology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011963","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Urinary and sexual symptoms are common following neurological disease, and we aimed to develop multidisciplinary inter\u2010society evidence\u2010based management guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The ADAPTE framework was used, and a systematic search of guidelines published in different languages was performed. Guidelines, consensus statements, and systematic reviews were included, and guideline quality was appraised using AGREE II. Patient representatives reviewed the relevance and suitability of recommendations. A modified Delphi process integrating the Evidence to Decision framework adapted from GRADE and the Oxford Centre for Evidence Based Medicine system was used to reach consensus on recommendation wording and strength.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Recommendations were drafted, using guidelines\/consensus statements (59 urinary, 50 sexual), systematic reviews (8 urinary, 2 sexual) and others (7 urinary,13 sexual), and wordings\/strengths achieved at least 80% consensus through 2 Delphi rounds. Eleven evidence\u2010based recommendations, 19 good practice statements, and 8 consensus\u2010based recommendations were made. Individuals with neurological diseases should be asked about urogenital symptoms and undergo targeted physical examination when appropriate. Urinary symptom assessments include urinalysis, bladder diary completion, and post\u2010void residual volume measurement. Treatments include fluid intake optimization, pelvic physiotherapy, tibial nerve stimulation, and oral medications. Urinary retention is managed by intermittent catheterization. Antibiotics should not be recommended to treat asymptomatic bacteriuria. Suprapubic catheterization is preferred for long\u2010term catheterization. A comprehensive sexual history should be taken, focusing on multidimensional factors affecting sexual health. Treatments include lubricants, vibrators, and phosphodiesterase\u20105 inhibitors. Red flag symptoms warrant a shared\u2010care approach with specialist colleagues.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The 38 NEUROGED recommendations will guide neurologists to comprehensively manage urogenital symptoms reported by individuals with neurological diseases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ene.70119","type":"journal-article","created":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T10:41:31Z","timestamp":1744281691000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["European Academy of Neurology (\n                    <scp>EAN<\/scp>\n                    )\/European Federation of Autonomic Societies (\n                    <scp>EFAS<\/scp>\n                    )\/International Neuro\u2010Urology Society (\n                    <scp>INUS<\/scp>\n                    ) Guidelines for Practising Neurologists on the Assessment and Treatment of Neurogenic Urinary and Sexual Symptoms (\n                    <scp>NEUROGED<\/scp>\n                    Guidelines)"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5190-3259","authenticated-orcid":false,"given":"Jalesh N.","family":"Panicker","sequence":"first","affiliation":[{"name":"Department of Uro\u2010Neurology The National Hospital for Neurology and Neurosurgery  London UK"},{"name":"UCL Queen Square Institute of Neurology, Faculty of Brain Sciences University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2854-4179","authenticated-orcid":false,"given":"Alessandra","family":"Fanciulli","sequence":"additional","affiliation":[{"name":"Department of Neurology Medical University of Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1087-3732","authenticated-orcid":false,"given":"Magdalena Krbot","family":"Skoric","sequence":"additional","affiliation":[{"name":"Department of Neurology, Referral Center for the Demyelinating Diseases of the Central Nervous System and Referral Center for the Autonomic Nervous System Disorders University Hospital Center Zagreb  Zagreb Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6262-6960","authenticated-orcid":false,"given":"Tamara","family":"Kaplan","sequence":"additional","affiliation":[{"name":"Department of Neurology Brigham and Women's Hospital  Boston Massachusetts USA"},{"name":"Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2372-4453","authenticated-orcid":false,"given":"Katina","family":"Aleksovska","sequence":"additional","affiliation":[{"name":"European Academy of Neurology  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3873-6526","authenticated-orcid":false,"given":"Ivan","family":"Adamec","sequence":"additional","affiliation":[{"name":"Department of Neurology, Referral Center for the Demyelinating Diseases of the Central Nervous System and Referral Center for the Autonomic Nervous System Disorders University Hospital Center Zagreb  Zagreb Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8127-7153","authenticated-orcid":false,"given":"Marcio Augusto","family":"Averbeck","sequence":"additional","affiliation":[{"name":"Neuro\u2010Urology at Moinhos de Vento Hospital (Johns Hopkins Affiliated)  Porto Alegre Brazil"},{"name":"Department of Urology Sao Lucas Hospital, PUCRS  Porto Alegre Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9980-3086","authenticated-orcid":false,"given":"Nicole","family":"Campese","sequence":"additional","affiliation":[{"name":"Department of Neurology Medical University of Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0597-603X","authenticated-orcid":false,"given":"Pietro","family":"Guaraldi","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Delle Scienze Neurologiche di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1714-5305","authenticated-orcid":false,"given":"Fabian","family":"Leys","sequence":"additional","affiliation":[{"name":"Department of Neurology Medical University of Innsbruck  Innsbruck 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Oxford 2011 Levels of Evidence","author":"OCEBM Levels of Evidence Working Group (Jeremy Howick ICJLL, Paul Glasziou, Trish Greenhalgh, Carl Heneghan, Alessandro Liberati, Ivan Moschetti, Bob Phillips, Hazel Thornton, Olive Goddard and Mary Hodgkinson, 2011)"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.12043"},{"key":"e_1_2_9_15_1","unstructured":"*B.Blok D.Castro Diaz G.Del Popolo et\u00a0al. \u201cEAU Guidelines on Neuro\u2010Urology\u201din \u201cEAU Guidelines. Edn. presented at the EAU Annual Congress Amsterdam 2022.\u201d2022."},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.5489\/cuaj.5912"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2008.159178"},{"key":"e_1_2_9_19_1","unstructured":"*\u201cUrinary Incontinence in Neurological Disease: Assessment and Management.\u201d(2012 NICE guideline CG148) https:\/\/www.nice.org.uk\/guidance\/cg148."},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.23397"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.24276"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345\u2010021\u201003804\u20104"},{"key":"e_1_2_9_23_1","unstructured":"*P.Abrams L.Cardozo A.Wagg andA.Wein eds. \u201cIncontinence 6th Edition (2017).\u201dInternational Continence Society;2017: pp. 599\u2013670: chap Committee 6: Urodynamics: Chair: Rosier Peter F.W.M."},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acuro.2017.01.006"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11255\u2010018\u20101852\u20107"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468\u20101331.2012.03806.x"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.24230"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/014107689408701116"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurol.2020.02.011"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.23939"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.23736\/s0393\u20102249.19.03447\u20107"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/iju.14186"},{"key":"e_1_2_9_33_1","unstructured":"*\u201cLower Urinary Tract Symptoms in Men: Management.\u201d(2010 NICE Clinical Guideline CG97) https:\/\/www.nice.org.uk\/guidance\/cg97."},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.11622\/smedj.2017082"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2014.12.038"},{"key":"e_1_2_9_36_1","unstructured":"*P.Abrams L.Cardozo A.Wagg andA.Wein eds. \u201cIncontinence 6th Edition.\u201d(2017). 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