Book reviewshttp://onlinetog.orgThe Obstetrician & Gynaecologist

E281© 2011Royal College of Obstetricians and Gynaecologists

Pelvic Organ Dysfunction inNeurological Disease: ClinicalManagement andRehabilitation

Editors Clare J Fowler / Jalesh N Panicker /Anton Emmanuel

Clare Fowler and her co-editors have attempted toprovide, for the first time in a single text, adescription of bowel, bladder and sexualdysfunction in the presence of neurologicaldisorder and a guide to evaluation andmanagement. The book is written mainly forclinicians with a special interest in these problemsand is a useful reference for the subspecialist andgeneralist interested in urogynaecology and pelvicfloor disorders. The text is written by 29contributors from numerous specialties anddisciplines, mainly based in the UK and Europe.The majority of these authors have worked withProfessor Fowler at the National Hospital forNeurology and Neurosurgery, Queen Square,London and the text reflects current practice in theUK rather than the USA. There is abundant cross-referencing between relevant chapters, largelyavoiding any repetition by different contributors.On the whole the book succeeds in its agenda and iswell laid out with numerous headings, diagramsand tables and each chapter is extensivelyreferenced to up-to-date literature.

The volume is divided into three sections. The firstsection, which addresses the neurological control ofthe pelvic organs, is well written and provides auseful review of the anatomy and physiology. Thesecond section ably addresses the evaluation andmanagement of bladder, bowel and sexual

dysfunction but does not mention ambulatoryurodynamics, measurements of bladder wallthickness, endoanal ultrasound, proctography orstraining magnetic resonance imaging. The thirdsection describes well the impact of specificneurological conditions on the activity of the pelvicorgans and in some chapters includes managementstrategies. The appendices offer useful referencealgorithms for the management of neurologicaldisease with associated bladder, bowel or sexualdysfunction.

It is gratifying that the authors have acknowledgedthe growing importance of patient-reportedoutcome measures. For reference they giveexamples of standardised questionnaires assessingbladder, bowel and sexual function, but it is ashame that they do not reference the InternationalConsultation on Incontinence Questionnaires nowrecommended by the British Society ofUrogynaecology.

In spite of a few small omissions, this is a usefulreference text for gynaecologists, urologists,coloproctologists and neurologists. It achieves itsgoal of being a single textbook with a holisticapproach to the evaluation and management ofpelvic floor dysfunction associated withneurological disorder.

Reviewer Christian Phillips DM MRCOG

Consultant Obstetrician and GynaecologistBasingstoke and North Hampshire FoundationTrust, Basingstoke, UK

Cambridge University Press, 2010ISBN: 9780521198318Hardcover, 358 pages, £65.0010.1576/toag.13.4.281.27700

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