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Advancing Personalized Care for Neurogenic Bladder What Medical Management Should be First Line for Bladder Storage
Aalya Hamouda1, Claudia Covarrubias2, Lysanne Campeau1,2
1Department of Surgery, Division of Urology, McGill University, Montreal, Québec, Canada.
Aims:
To discuss the benefits and considerations of anticholinergic therapy as first-line treatment for bladder storage symptoms in patients with neurogenic lower urinary tract dysfunction (NLUTD), integrating evidence-based data and clinical experience.
Methods:
A narrative review of international guideline recommendations, available clinical evidence, and professional experience was undertaken to evaluate the role of anticholinergics in managing disorders of bladder storage, such as neurogenic detrusor overactivity (NDO) and intrinsic sphincter dyssynergia (NISD), in patients with NLUTD.
Results:
Evidence from published studies and guideline statements supports anticholinergics as effective agents for improving lower urinary tract symptoms (LUTS), detrusor overactivity (DO), and overall bladder function in patients with NLUTD. Their use has also been associated with prevention of secondary urinary complications.
Conclusions:
Anticholinergics remain recommended first-line therapy for bladder storage dysfunction in NLUTD. Clinical use should be guided by individual patient characteristics, balancing efficacy in symptom control with potential side effects and long-term safety considerations.
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