The Shifting Paradigm of Treating Neurogenic Bladder Patients After the Introduction of Neuromodulation

Over the last 10 years, there have been an increasing number of treatment options for patients with neurogenic bladder. We conducted a literature review of the most current research on mirabegron, onabotulinumtoxin A, sacral nerve modulation (SNM), and posterior tibial nerve stimulation (PTNS) as it pertains to neurogenic bladder. In addition to discussing these treatments, we also discuss how these treatments pertain to the most common etiologies of neurogenic bladder: multiple sclerosis (MS), spinal cord injury (SCI) and Parkinson’s Disease. Each of the above treatment modalities has been shown to be effective in these populations, with the most research behind onabotulinumtoxin A. While SNM and PTNS appear promising, more research is needed with bigger populations to fully elucidate the benefits of these treatments. The decision on which treatment is best for each patient should be individualized based on a patient’s symptoms, disease, and his or her unique preferences.