Editing CUA: Neurogenic Lower Urinary Tract Dysfunction (2019) (section)

==== Anticholinergics ====
* '''<span style="color:#ff0000">First-line pharmacological treatment for patients with NLUTD'''
* '''<span style="color:#ff0000">Indications'''
**'''<span style="color:#ff0000">Should be offered to people with urodynamic findings of NDO or those with SCI and symptoms of overactive bladder (OAB)'''
** '''<span style="color:#ff0000">Should be considered whether or not patients are using assisted bladder drainage.'''
*** '''Absence of its usage has been shown to be a risk factor for upper tract deterioration'''
* '''<span style="color:#ff0000">Use improves OAB symptoms and NDO, decreases urgency urinary incontinence, and lowers detrusor pressures'''
* '''<span style="color:#ff0000">Do not alter the detrusor or abdominal leak point pressures since they do not act on the external urethral sphincter'''
* '''Studies that compared one medication to another''' (usually oxybutynin IR) '''did not reveal statistically significant differences.''' The optimal drug dosage was not identified.
* '''Supratherapeutic dosages may be considered according to tolerability''' but should be used cautiously.
* '''Combining antimuscarinics may be beneficial for patients who are refractory to dose escalation antimuscarinic monotherapy'''
* '''There is very limited data supporting the use of transdermal oxybutynin in NLUTD'''