In this episode of Bladder Buzz, Dr. David Ginsberg, Chief of Urology at Rancho Los Amigos National Rehabilitation Center, discusses bladder management options for individuals with Neurogenic Lower Urinary Tract Dysfunction (NLUTD) when oral medications are no longer sufficient. We explore how clinicians recognize when it’s time to consider next steps and review options such as Botox, neuromodulation, catheter-based strategies, and surgical reconstruction. Dr. Ginsberg explains how treatment decisions are individualized, including important safety, lifestyle, and quality-of-life considerations. This episode offers reassurance that many effective options remain available, even when first-line treatments have not worked.