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Reduced compliance and detrusor overactivity lead to high filling pressures and raised detrusor leak point pressure, playing urodynamic studies a crucial role in risk assessment, though further research is needed for different neurogenic populations. Congenital conditions such as spina bifida, posterior urethral valves, and bladder exstrophy also contribute to a high\u2010risk bladder through fibrosis and reduced compliance. Inflammation and ischemia are key factors, with inflammation leading to fibrosis and impaired bladder storage and voiding function. Novel treatments, including sGC activators, PDE5 inhibitors, and regenerative therapies like stem cell injections and extracorporeal shock wave treatment, show promise in mitigating fibrosis and improving bladder compliance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Identifying and validating clinical risk stratification models, precise biomarkers and therapeutic windows remains essential for effective management and reversal of bladder fibrosis and dysfunction.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nau.25604","type":"journal-article","created":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T11:09:55Z","timestamp":1730286595000},"page":"539-547","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Think Tank 2: How Do We Precisely Define the \u201cHigh Risk Bladder\u201d and What Are the Interrelationships Between Inflammation, Blood Flow, Fibrosis, and Loss of Bladder 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