European Association of Urology Guidelines on Neuro-urology: Summary of the 2026 Update

Abstract

Context

Neurological disorders frequently impair the lower urinary tract, sexual, and reproductive function and require lifelong, individualised management. This review summarises the latest update of the European Association of Urology (EAU) Guidelines on Neuro-Urology, highlighting refined terminology, a stronger patient-centred approach, and current diagnostic and therapeutic strategies.

Objective

To present a summary of the 2026 Neuro-Urology guideline updated using a standardised methodology to provide reproducible evidence for the management of neuro-urology.

Evidence acquisition

Recommendations are derived from the updated EAU Neuro-Urology Guidelines following structured evaluation of recent literature and expert panel consensus. Evidence levels, risk–benefit considerations, and patient perspectives informed the formulation of clinically oriented recommendations.

Evidence synthesis

Early risk stratification, urodynamic evaluation, and regular surveillance remain central to preventing complications. Conservative and pharmacological therapies are first-line treatments, whereas minimally invasive and surgical options should be individualised according to neurological status and patient preference. Updated sections reflect refined terminology, integration of patient perspectives, and expanded guidance on urinary tract infection management, neuromodulation, reconstructive strategies, and sexual and reproductive health. Evidence remains heterogeneous, and high-level comparative data are limited for several interventions.

Conclusions

The updated Guidelines emphasise protection of upper urinary tract function, optimisation of bladder dynamics, and shared decision-making within multidisciplinary care. Integration of sexual health and structured long-term follow-up reflects the evolving needs of patients with neurological conditions.