Urol. praxi. 2026;27(1):23-30 | DOI: 10.36290/uro.2025.077

Treatment of urinary dysfunctions in adult patients with neurological diseases

doc. MUDr. Jozef Marenčák, PhD.
Bratislava

Neurogenic lower urinary tract dysfunction significantly impairs patients´ quality of life, is associated with numerous life-threatening complications, and represents a significant economic burden on healthcare system. Diagnosis is based on patient history, physical examination, imaging procedures, and urodynamic testing, with the need to determine the individual risk level. The goals of treatment include preser­ving renal function, improving quality of life, preventing urinary tract infection, and maintaining a low-pressure bladder that is boht continent and capable of comlete emptying. The article provides an overview of current treatment options for patients with neurogenic lower urinary tract dysfunction.

Keywords: neurogenic lower urinary tract dysfunction, patient risk stratification, treatment options.

Received: October 2, 2025; Revised: October 2, 2025; Accepted: October 5, 2025; Published: March 16, 2026  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Marenčák J. Treatment of urinary dysfunctions in adult patients with neurological diseases. Urol. praxi. 2026;27(1):23-30. doi: 10.36290/uro.2025.077.
Download citation

References

  1. Kavanagh A, Baverstock R, Campeau L, et al. Canadian Urological Association guideline: diagnosis, management, and surveillance of neurogenic lower urinary tract dysfunction - full text. Can Urol Assoc. 2019;13(6):57-76. Go to original source...
  2. Blok B, Castro-Diaz D, Del Popolo G, et al. EAU guidelines on neuro-urology. Available from: https://uroweb.org/guidelines, prístup od 1. 8. 2025.
  3. Ginsberg D, Boone T, Cameron A, et al. The AUA/SUFU guideline on adult neurogenic lower urinary tract dysfunction: diagnosis and evaluation. J Urol. 2021;206(5):1097-1105. Go to original source...
  4. Panicker J, Fanciulli A, Skoric M, et al. European Academy of Neurology (EAN)/ European Federation of Autonomic Societies (EFAS)/ International Neuro-Urology Society (INUS) guidelines for practising neurologists on the assessment and treatment of neurogenic urinary and sexual symptoms (NEUROGED guidelines). Eur J Neurol. 2025;32:e70119. Go to original source...
  5. Záleský M. Konzervativní terapie neurogenních dysfunkcí dolních močových cest - 2. část. Urol. Praxi. 2021;22(3):109-113. Go to original source...
  6. Sedláčková L. Urologické komplikace u pacientu s roztroušenou sklerózou. Urol. Praxi. 2024;25(2):68-71. Go to original source...
  7. Marenčák J. Konzervatívna a minimálne invazívna liečba neurogénnej dysfunkcie dolných močových ciest u dospelých pacientov. Klin Urol. 2024;20(1):22-30.
  8. McDonald C, Rees J, Winge K, et al. Bladder training for urinary tract symptoms in Parkinson disease: a randomized controled trial. Neurology. 2020;94(13):1427-1433. Go to original source...
  9. Wagg A, Abrams P, Andersson K, et al. Recommendations of the International Scientific Commitee. In: Cardozo L, Rovner E, Wagg A, et al. Incontinence. 7th ed; 2023.
  10. Cornu J, Hashim H, Van Der Aa F, et al. How I do it: transcutaneous tibial nerve stimulation TENSI+ system. Can J Urol. 2023;30(6):11756-11761.
  11. Leslie S, Tadi P, Tayyeb M. Neurogenic bladder and neurogenic lower urinary tract dysfunction. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560617/.
  12. Mancini V, Damaser M, Chermansky Ch, et al. Can we improve techniques and patients selection for nerve stimulation suitable for lower urinary tract dysfunctions? ICI-RS 2023. Neurourol Urodyn. 2024;43(6):1420-1430. Go to original source...
  13. Mandy F, Murphy C, Bliss D, et al. Management using continence products. In: Cardozo L, Rovner E, Wagg A, et al. Incontinence. 7th ed; 2023.
  14. Marenčák J. Diagnostika a manažment neurogénnych dysfunkcií dolných močových ciest u dospelých pacientov. Via practica. 2024;21(1):21-28.
  15. Kreydin E, Gomes C, Cruz F. Current pharmacotherapy of overactive bladder. Int Braz J Urol. 2021;47(6):1091-1107. Go to original source...
  16. Schröder A, Albrecht U, Schnitker J, et al. Efficacy, safety, and tolerability of intravesically administered 0.1% oxybutynin hydrochlorid solution in adult patients with neurogenic bladder: a randomized, prospective, controlled multicenter trial. Neurourol Urodyn. 2016;35(5):582-588. Go to original source...
  17. Lee K, Takahashi R, Imada K, et al. Initial experience with vibegron for treatment of neurogenic lower urinary tract storage dysfunction in patients with spinal cord injury. Continence. 2022;4:100516. Go to original source...
  18. Schneider M, Tornic J, Sýkora R, et al. Alpha-blockers for treating neurogenic lower urinary tract dysfunction in patients with multiple sclerosis: a systematic review and meta-analysis. A report from the Neuro-Urology Promotion Committee of the International Continence Society (ICS). Neurourol Urodyn. 2019;38(6):1482-1491. Go to original source...
  19. Phé V, Schneider M, Peyronnet B, et al. Desmopressin for treating nocturia in patients with multiple sclerosis: a systematic review: a report from the neuro-urology promotion committee of the International Continence Society (ICS). Neurourol Urodyn. 2019;38(2):563-571. Go to original source...
  20. Haddad R, Denys P, Arlandis S, et al. Nocturia and nocturnal polyuria in neurological patients: from epidemiology to treatment. A systematic review of the literature. Eur Urol Focus. 2020;6(5):922-934. Go to original source...
  21. Konstantinidis Ch, Finazzi-Agró E, Panicker J, et al. Autonomic dysreflexia (AD): a serious, rather underestimated condition, a review based on workshop 11, held on ICS Vienna 2022. Continence. 2023;6:100595. Go to original source...
  22. Chapple Ch, Abrams P, Lam T, et al. A consensus statement on when to start clean intermittent self-catheterization: an untapped resource? Neurourol Urodyn. 2023;1-5.
  23. Ong H, Chiang I, Hsu L, et al. Conservative bladder mana­gement and medical treatment in chronic spinal cord injury patients. J Clin Med. 2023;12(5):2021. Go to original source...
  24. Cooley L, Kielb S. A review of botulinum toxin A for the treatment of neurogenic bladder. PM R. 2019;11(2):192-200. Go to original source...
  25. Wu S, Xu Y, Gao Z, et al. Clinical outcomes of botulinum toxin A management for neurogenic detrusor overactivity: meta-analysis. Ren Fail. 2019;41(1):937-945. Go to original source...
  26. Young M, Osman N, Phillips L, et al. Another therapeutic role for intravesical botulinum toxin: patients with long-stay catheters and refractory bladder pain and catheter bypass leakage. Eur Urol Focus. 2020;6(2):339-343. Go to original source...
  27. Bottet F, Peyronett B, Boissier R, et al. Switch to abobotulinum toxin A may be useful in the treatment of neurogenic detrusor overactivity when intradetrusor injections of onabotulinum toxin A failed. Neurourol Urodyn. 2018;37(1):291-297. Go to original source...
  28. Cruz F, Danchenko N, Fahrbach K, et al. Efficacy of abobotulinumtoxinA versus abobotulinumtoxinA for the treatment of refractory nerogenic detrusor overactivity: a systematic review and indirect treatment comparison. J Med Econ. 2023;26(1):200-207. Go to original source...
  29. Fan Y, Shen Y, Hsu C, et al. Current surgical treatment for neurogenic lower urinary tract dysfunction in patients with chronic spinal cord injury. J Clin Med. 2023;12(4):1400. Go to original source...
  30. Sakalis V, Floyd M, Caygill P, et al. Management of stress urinary incontinence in spinal cord injured female patients with a mid-urethral tape - A single center experience. J Spinal Cord Med. 2018;41(6):703-709. Go to original source...
  31. Guillot-Tantay, C, Chartier-Kastler E, Mozer P, et al. Male neurogenic stress urinary incontinence treated by artificial urinary sphincter AMS 800 (Boston Scientific, Boston, USA): Very long-term results (>25 years). Prog Urol. 2018;28(1):39-47. Go to original source...
  32. Tricard T, Schirmann A, Munier P, et al. Outcomes of artificial urinary sphincter in female with neurological stress urinary incontinence: a long-term follow-up. World J Urol. 2021;39(1):157-162. Go to original source...
  33. Vrijens D, Kendall H, Hervé F. Neurological sphincter deficiency: is there a place for artificial urinary sphincter? World J Urol. 2024;42(1):69. Go to original source...
  34. Wang C, Chung D. Neuromodulation for lower urinary tract symptoms in special populations. Neurourol Urodyn. 2022;41(8):1948-1957. Go to original source...
  35. Vogel K, Nakib N. Off-label but on-target: sacral neuromodulation for neurogenic bladder dysfunction. Curr Urol Rep. 2025;26(1):52. Go to original source...
  36. Cheng P, Keihani S, Roth J, et al. Contemporary multicenter outcomes of continent cutaneous ileocecocystoplasty in the adult population over a 10-year period: A Neuro­genic Bladder Research Group study. Neurourol Urodyn. 2020;39(6):1771-1780. Go to original source...
  37. Phé V, Boissier R, Blok B, et al. Continent catheterizable tubes/stomas in adult neuro-urological patients: A systematic review. Neurourol Urodyn. 2017;36(7):1711-1722. Go to original source...
  38. Marenčák J. Možnosti a limity invazívnej liečby u neurourologických pacientov. Klin Urol. 2018;14(3):118-123.
  39. Wang X, Zhang F, Liao L. Current applications and future directions of bioengineering approaches for bladder augmentation and reconstruction. Front Surg. 2021;8:664404. Go to original source...
  40. Akakpo W, Chartier-Kastler E, Joussain Ch, et al. Outcomes of ileal conduit urinary diversion in patients with multiple scle­rosis. Neurourol Urodyn. 2020;39(2):771-777. Go to original source...
  41. Mazoulin C, Hubert J, Tricard T, et al. Robot-assisted cystectomy and ileal conduit for neurogenic bladder: comparison of extracorporeal vs intracorporeal urinary diversion. J Endourol. 2021;35(9):1350-1356. Go to original source...
  42. Wang W, Xie P, Zhang J, et al. A risk prediction model of urinary tract infections for patients with neurogenic bladder. Int J Neurosci. 2021;131(1):31-39. Go to original source...




Urology for Practice

Madam, Sir,
please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

I declare:

  1. that I have met the above instruction
  2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited


No

Yes

If your statement is not true, please be aware
that brings the risk of danger to their health or the health of others.