Managing a neurogenic bladder can often require a mix of lifestyle changes and medical treatments chosen to meet your specific needs. Examples of effective interventions include:

1. Dietary changes

• Avoiding bladder irritants like caffeine, alcohol, and acidic foods
• Staying hydrated and managing constipation to reduce bladder pressure
• If diabetes is a factor, controlling blood sugar levels to minimize nerve damage

2. Bladder retraining

Bladder retraining means slowly increasing the time between bathroom trips. This helps your bladder hold urine better. Following a scheduled voiding routine can make this process more effective.

3. Catheterization

Catheterization may be performed to alleviate urinary retention and comes in two main types:
Intermittent catheterization: a catheter is inserted as needed to empty the bladder and then removed
Continuous catheterization: a catheter remains in place for constant drainage

4. Medications

Medications are prescribed to manage various symptoms. Depending on your needs, these medications may:

• Relax bladder muscles. Drugs such as anticholinergics or beta-3 agonists help calm overactive bladder muscles. This reduces the sense of urgency and frequent trips to the bathroom.
• Stimulate bladder contractions. Medications like cholinergic agents can promote stronger bladder contractions. They help to improve emptying for those with weak bladder function.

5. Botox injections

Botulinum toxin (Botox) injections effectively relax the bladder muscles. Botox minimizes involuntary contractions, decreasing symptoms such as urgency, frequency, and incontinence. The effects of these injections last about six months, after which the procedure can be repeated to maintain symptom relief.

6. Neuromodulation

Neuromodulation therapies stimulate bladder-control nerves. They improve communication between the brain and bladder by "resetting" the nerves. Two techniques for managing symptoms are:

• Sacral neuromodulation. This involves implanting a small device under the skin near the lower back to stimulate the sacral nerves, which play a key role in bladder control. An example is InterStim.
• Percutaneous tibial nerve stimulation. This is a less invasive option. It involves inserting a thin needle near the ankle to stimulate the tibial nerve. This indirectly influences bladder function. An example is NURO PTNM.

8. Surgical options

When other treatments are ineffective, surgery may be considered. Common surgical options include:

• Bladder augmentation. Increases the bladder's capacity by using a piece of the intestine to expand the bladder wall.
• Urinary diversion. In cases where the bladder cannot function properly, a new pathway is created for urine to exit the body.