K - BLADDER FUNCTION
Oral antimuscarinics with dose-escalation are the first-line pharmacological treatment for patients with neurogenic lower urinary tract dysfunction in order to improve overactive bladder symptoms and neurogenic detrusor overactivity, decrease urgency urinary incontinence and lower detrusor pressures (CUA 2019, p.166; Level A)
Mirabegron may be a useful alternative to antimuscarinics for individuals with symptoms of overactive bladder and neurogenic lower urinary tract dysfunction, but further evidence of urodynamic changes is needed in this population. (CUA 2019, p.167; Level B)
Clinicians should monitor residual urine volume in individuals with SCI who are not using intermittent or indwelling catheterization after starting antimuscarinic treatment. Once therapy is initiated, clinicians should monitor for signs and symptoms of urinary retention. (Adapted from NICE 2012, p.116; Level B)