Managing Neurogenic Bladder in Men

Neurogenic Lower Urinary Tract Dysfunction (NLUTD)—also known as neurogenic bladder—occurs when damage or disease affecting the nervous system impairs bladder control. This condition can be caused by spinal cord injury, stroke, multiple sclerosis, or other neurological disorders. NLUTD can present as overactive bladder, underactive bladder, detrusor-sphincter dyssynergia (loss of coordination between bladder and sphincter muscles), or a combination of these patterns.

Although there is no cure for NLUTD, many effective management options can help men live a full and active life. Managing symptoms is essential not only to protect the kidneys and urinary tract but also to support mental well-being, social life, and independence.

Treatment options include:

• Lifestyle changes like timed voiding (urinating on a schedule), double voiding, and avoiding foods or medications that irritate the bladder.

• Pelvic floor therapy, which can help coordinate the pelvic muscles for better control.

• Medications or BOTOX® injections to relax the bladder and reduce spasms.

• Catheterization, either intermittent ("in and out") or indwelling (continuous drainage), via the urethra or a surgically created stoma in the lower abdomen.

• Surgical procedures, depending on the severity:

  • Bladder augmentation (using bowel tissue to enlarge the bladder),

  • Urinary diversion for easier catheter access through a stoma,

  • Sphincterotomy or sphincter resection to help urine flow more easily,

  • Artificial urinary sphincter, which includes an inflatable cuff around the urethra to reduce leakage, controlled by a pump under the skin.

With the right approach, many men with NLUTD can significantly reduce urinary incontinence episodes, prevent complications, and regain control over their daily life. Discuss these options with your urologist to find what works best for your needs and lifestyle.

Spina Bifida Association. (2022, May). Managing Neurogenic Lower Urinary Tract Dysfunction (NLUTD) [Fact sheet]. Spina Bifida Association. https://www.spinabifidaassociation.org/wp-content/uploads/Managing-NLUTD-Factsheet_2022_05_d2-FINAL.pdf