Bladder, bowel, and sexual dysfunction are overlooked in the management of neurological conditions: a qualitative interview study
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Published version (article in press)
Author(s)
Type
Journal Article
Abstract
Background
One in six people in the UK live with a neurological condition, of which many experience bladder, bowel and sexual dysfunction that are present during the time of neurological diagnosis. However, it not clear whether their bladder, bowel or sexual symptoms are considered when formulating a neurological diagnosis. This study aimed to explore the patients experiences of being diagnosed with and managing neurological conditions and the considerations of their bladder, bowel and sexual symptoms.
Methods
Semi-structured qualitative interviews were conducted with patients with a diverse range of neurological conditions. Interviews were recorded and transcribed verbatim and analysed using reflexive thematic analysis. A patient and public involvement group supported the pilot testing of the topic guide and the data analysis.
Results
Twenty participants (12 female, 1 non-binary and 7 male) aged between 30 and 83 and 13/20 people from the global majority participated in the study. Four themes and ten subthemes were identified: (1) Challenges within healthcare – dismissive encounters with healthcare professionals and systemic pressures directly impacting care. (2) Understanding and Advocacy – insufficient communication, education and expectation management across contexts, “I am the ruler of my own self”- self advocacy is essential and peer support. (3) Emotional and Psychological Impact – Grief – “you go through the grieving cycle; you’ve lost a bit of yourself” and difficulty describing sensations. (4) Sex Matters – Gender differences and sex remains a low priority within healthcare.
Conclusions
The findings demonstrate that during diagnosis of neurological conditions bladder bowel and sexual symptoms are overlooked in building the clinical picture, and the needs of managing these emotionally challenging and difficult symptoms are not being effectively met by the healthcare system at present.
One in six people in the UK live with a neurological condition, of which many experience bladder, bowel and sexual dysfunction that are present during the time of neurological diagnosis. However, it not clear whether their bladder, bowel or sexual symptoms are considered when formulating a neurological diagnosis. This study aimed to explore the patients experiences of being diagnosed with and managing neurological conditions and the considerations of their bladder, bowel and sexual symptoms.
Methods
Semi-structured qualitative interviews were conducted with patients with a diverse range of neurological conditions. Interviews were recorded and transcribed verbatim and analysed using reflexive thematic analysis. A patient and public involvement group supported the pilot testing of the topic guide and the data analysis.
Results
Twenty participants (12 female, 1 non-binary and 7 male) aged between 30 and 83 and 13/20 people from the global majority participated in the study. Four themes and ten subthemes were identified: (1) Challenges within healthcare – dismissive encounters with healthcare professionals and systemic pressures directly impacting care. (2) Understanding and Advocacy – insufficient communication, education and expectation management across contexts, “I am the ruler of my own self”- self advocacy is essential and peer support. (3) Emotional and Psychological Impact – Grief – “you go through the grieving cycle; you’ve lost a bit of yourself” and difficulty describing sensations. (4) Sex Matters – Gender differences and sex remains a low priority within healthcare.
Conclusions
The findings demonstrate that during diagnosis of neurological conditions bladder bowel and sexual symptoms are overlooked in building the clinical picture, and the needs of managing these emotionally challenging and difficult symptoms are not being effectively met by the healthcare system at present.
Date Issued
2026-06-05
Date Acceptance
2026-05-27
Citation
BMC Neurology, 2026
ISSN
1471-2377
Publisher
BMC
Journal / Book Title
BMC Neurology
Copyright Statement
© The Author(s) 2026. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
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Publication Status
Published online
Date Publish Online
2026-06-05