Autonomous bladder training for neurogenic bladder: a randomized controlled trial
In brief
Autonomous bladder training cuts post-void residual by about 56 mL in neurogenic bladder
In a single-center RCT of 168 adults, a 4-week autonomous bladder training program reduced residual urine volume by an average of 56 mL more than routine rehabilitation, with 80% achieving at least a 50-mL drop versus 43% with standard care. The regimen also improved flow rates, bladder pressure and symptom scores, lowered urinary-tract infection rates, and showed partial durability at 12 weeks, though larger multicenter trials are needed.
- Journal
- Journal of rehabilitation medicine (Q1)
- Published
- 23 July 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Yue Yang, Lianchi Li, Jing Ye, Hongxia Pan, Jianmei Zhang, Li Zeng, et al.
- PMID
- 42488971
- DOI
- 10.2340/jrm.v58.45818
Why clinicians should know about it
- Picked for Rehabilitation (paper of the day, 24 July 2026).
- Picked for Urology (paper of the day, 24 July 2026): Autonomous bladder training reduces residual volume and UTIs
Abstract
BACKGROUND: Neurogenic bladder causes impaired bladder emptying, urinary complications, and reduced quality of life. This trial evaluated whether structured multimodal autonomous bladder training improves bladder function in patients with neurogenic bladder. METHODS: In this single-centre randomized controlled trial, 168 adults were assigned 1:1 to autonomous bladder training plus routine rehabilitation care or routine care alone. The 4-week intervention included induced voiding, sensory awareness training, pelvic floor muscle training, bladder-sphincter coordination exercises, and bladder desensitization. The primary outcome was change in post-void residual urine volume (RUV) at 4 weeks. Secondary outcomes included urodynamic parameters, Neurogenic Bladder Symptom Score (NBSS), symptomatic urinary tract infection (UTI) requiring antibiotics, and adverse events. RESULTS: At 4 weeks, RUV improved more with autonomous bladder training than with routine care (adjusted mean difference in change, -55.8 mL; 95% CI, -64.7 to -46.9). Maximum urinary flow rate, maximum detrusor pressure, and NBSS also favoured the intervention. RUV reduction ≥50 mL occurred in 79.8% versus 42.9% of participants. Symptomatic UTI requiring antibiotics occurred in 9.5% versus 27.4%, although urine culture confirmation was incomplete. Exploratory 12-week follow-up suggested partial maintenance of benefit. Adverse events were uncommon, and no serious adverse events occurred. CONCLUSIONS: Autonomous bladder training improved short-term urodynamic and patient-reported outcomes, with exploratory evidence of partial benefit maintenance at 12 weeks. Infection-related findings require cautious interpretation because culture confirmation was incomplete. Longer multicentre trials are warranted.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.