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 part of a more generalized neuropathy. The latter occurs in a limited number of conditions including diabetes mellitus, amyloid neuropathy (familial or acquired), porphyria and Guillain-Barre syndrome (GBS). In GBS, bladder and bowel symptoms are in fact a red flag indicating the clinician should consider a more central, spinal cord diagnosis. Bladder, bowel and sexual dysfunction in association with motor and sensory symptoms and signs will also be encountered in conditions that primarily involve the nerve roots (radiculopathies) in, for example, presentations with herpes varicella zoster and simplex, cytomegalovirus (CMV), Borrelia infections (Lyme disease) and in infiltrative conditions such as with lymphoma or sarcoidosis. Bladder, bowel and sexual dysfunction in purely muscular disorders are unusual and their presence would necessitate the search for an alternative etiology.
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