{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T11:31:27Z","timestamp":1787225487753,"version":"build-2736575974"},"reference-count":61,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Urol."],"abstract":"<jats:p>Artificial intelligence (AI) and machine learning are increasingly applied across urology, with particular promise for the management of neurogenic lower urinary tract dysfunction (NLUTD) in individuals with spinal cord injury (SCI). There is also particular promise in the management of NLUTD, a complex, lifelong condition affecting individuals with SCI and also occurring in the context of multiple sclerosis, Parkinson\u2019s disease, and other neurological disorders. This article provides a comprehensive analysis of AI\u2019s current and emerging role in neuro-urology, with dedicated focus on the specific challenges and opportunities presented by NLUTD and SCI. We review the epidemiological and clinical burden of neurogenic bladder dysfunction. We further examine AI applications in uro-oncology, functional urology, digital pathology, and robotic surgery, integrating these with the specialized perspective of neuro-urology. The particular vulnerability of individuals with SCI to algorithmic bias, access inequity, and assistive technology dependency is critically discussed. We identified five key domains where AI may transform care for patients with NLUTD: automated urodynamic interpretation including detection of detrusor overactivity and detrusor-sphincter dyssynergia, predictive risk stratification for renal deterioration, closed-loop neuromodulation, remote digital monitoring, and AI-assisted rehabilitation support. Alongside the substantial opportunities, we articulate the ethical, moral, and societal responsibilities that accompany AI integration in this population, emphasizing that patients with SCI and NLUTD deserve not merely inclusion in AI development but active partnership as co-designers of the technologies that will shape their lives.<\/jats:p>","DOI":"10.3389\/fruro.2026.1931923","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T04:21:41Z","timestamp":1786076501000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Artificial intelligence and machine learning in neurogenic lower urinary tract dysfunction and spinal cord injury: current status, emerging technologies, and ethical perspectives"],"prefix":"10.3389","volume":"6","author":[{"given":"Patrick M. F.","family":"Levien","sequence":"first","affiliation":[{"name":"Neuro-Urology, Swiss Paraplegic Center","place":["Nottwil, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Pannek","sequence":"additional","affiliation":[{"name":"Neuro-Urology, Swiss Paraplegic Center","place":["Nottwil, Switzerland"]},{"name":"Department of Urology, Inselspital, Bern University Hospital, University of Bern","place":["Bern, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.2196\/45815","article-title":"Mapping the bibliometrics landscape of AI in medicine: methodological study","volume":"25","author":"Shi","year":"2023","journal-title":"J Med Internet Res"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.2196\/18228","article-title":"Artificial intelligence in health care: bibliometric analysis","volume":"22","author":"Guo","year":"2020","journal-title":"J Med Internet Res"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1111\/bju.14852","article-title":"Current status of artificial intelligence applications in urology and their potential to influence clinical practice","volume":"124","author":"Chen","year":"2019","journal-title":"BJU Int"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2025.1619378","article-title":"Integrative review of artificial intelligence applications in nursing: education, clinical practice, workload management, and professional perceptions","volume":"13","author":"El Arab","year":"2025","journal-title":"Front Public Health"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1002\/nau.70074","article-title":"The future of urodynamics: innovations, challenges, and possibilities","volume":"45","author":"Chew","year":"2026","journal-title":"Neurourol Urodyn"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1002\/nau.25606","article-title":"How can we show that artificial intelligence may improve our assessment and management of lower urinary tract dysfunctions?-ICI-RS 2024","volume":"44","author":"Finazzi Agro","year":"2025","journal-title":"Neurourol Urodyn"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2021.09.027","article-title":"Machine learning for urodynamic detection of detrusor overactivity","volume":"159","author":"Hobbs","year":"2022","journal-title":"Urology"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1109\/jtehm.2025.3544486","article-title":"Automated evaluation of urodynamic examinations through local linear models: validation on spinal cord injury individuals","volume":"13","author":"Zhang","year":"2025","journal-title":"IEEE J Transl Eng Health Med"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2009.04.028","article-title":"EAU guidelines on neurogenic lower urinary tract dysfunction","volume":"56","author":"Stohrer","year":"2009","journal-title":"Eur Urol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/s0022-5347(05)67283-7","article-title":"Botulinum-A toxin for treating detrusor hyperreflexia in spinal cord injured patients: a new alternative to anticholinergic drugs? Preliminary results","volume":"164","author":"Schurch","year":"2000","journal-title":"J Urol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1007\/s00345-025-06097-z","article-title":"Artificial inteligence reading of cystometric traces provides good correlation with human diagnosis","volume":"44","author":"Batista-Miranda","year":"2025","journal-title":"World J Urol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1089\/end.2023.0263","article-title":"Trends of \"Artificial Intelligence, Machine Learning, Virtual Reality, and Radiomics in Urolithiasis\" over the last 30 years (1994-2023) as published in the literature (PubMed): a comprehensive review","volume":"38","author":"Nedbal","year":"2024","journal-title":"J Endourol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1038\/s44172-025-00451-0","article-title":"Ultrasonographic-guided robotic-assisted percutaneous nephrolithotomy","volume":"4","author":"Bazzani","year":"2025","journal-title":"Commun Eng"},{"key":"B14","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1186\/s12894-024-01400-3","article-title":"Percutaneous nephrolithotomy guided by 5G-powered robot-assisted teleultrasound diagnosis system: first clinical experience with a novel tele-assistance approach (IDEAL stage 1)","volume":"24","author":"Yang","year":"2024","journal-title":"BMC Urol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-019-03037-6","article-title":"Artificial intelligence and robotics: a combination that is changing the operating room","volume":"38","author":"Andras","year":"2020","journal-title":"World J Urol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16091775","article-title":"Artificial intelligence in urologic robotic oncologic surgery: a narrative review","volume":"16","author":"Bellos","year":"2024","journal-title":"Cancers (Basel)"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-025-17228-6","article-title":"Recent advances in artificial intelligence for precision diagnosis and treatment of bladder cancer: a review","volume":"32","author":"Yang","year":"2025","journal-title":"Ann Surg Oncol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1111\/his.70020","article-title":"Artificial intelligence in genitourinary pathology","volume":"88","author":"Patel","year":"2026","journal-title":"Histopathology"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1002\/nau.25319","article-title":"Can we use machine learning to improve the interpretation and application of urodynamic data?: ICI-RS 2023","volume":"43","author":"Gammie","year":"2024","journal-title":"Neurourol Urodyn"},{"key":"B20","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1002\/nau.70160","article-title":"Application of large language models in automated interpretation of urodynamic parameters","volume":"45","author":"Wang","year":"2026","journal-title":"Neurourol Urodyn"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1002\/nau.70308","article-title":"Applications of artificial intelligence in urodynamic data interpretation: a narrative review","author":"Pourghazi","year":"2026","journal-title":"Neurourol Urodyn"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2025.08.022","article-title":"Artificial intelligence for objective assessment of pediatric uroflowmetry curves","volume":"206","author":"Yucel","year":"2025","journal-title":"Urology"},{"key":"B23","doi-asserted-by":"publisher","first-page":"994","DOI":"10.1097\/ju.0000000000003267","article-title":"Deep learning of videourodynamics to classify bladder dysfunction severity in patients with spina bifida","volume":"209","author":"Weaver","year":"2023","journal-title":"J Urol"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1097\/ju.0000000000004547","article-title":"Machine learning analysis of videourodynamics to predict incident hydronephrosis in patients with spina bifida","volume":"214","author":"Weaver","year":"2025","journal-title":"J Urol"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-019-03000-5","article-title":"Current and future applications of machine and deep learning in urology: a review of the literature on urolithiasis, renal cell carcinoma, and bladder and prostate cancer","volume":"38","author":"Suarez-Ibarrola","year":"2020","journal-title":"World J Urol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14144942","article-title":"Use of artificial intelligence methods for improved diagnosis of urinary tract infections and urinary stone disease","volume":"14","author":"Pantilimonescu","year":"2025","journal-title":"J Clin Med"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.5213\/inj.1836246.123","article-title":"Detecting bladder biomarkers for closed-loop neuromodulation: a technological review","volume":"22","author":"Park","year":"2018","journal-title":"Int Neurourol J"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1007\/s11884-022-00665-4","article-title":"NIRS: past, present, and future in functional urology","volume":"17","author":"Koven","year":"2022","journal-title":"Curr Bladder Dysfunct Rep"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.3389\/fbioe.2025.1717576","article-title":"Toward virtual bladder: real-time bladder volume monitoring with flexible AuCNT strain sensors","volume":"13","author":"Cho","year":"2025","journal-title":"Front Bioeng Biotechnol"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1109\/tnsre.2019.2912374","article-title":"Real-time bladder pressure estimation for closed-loop control in a detrusor overactivity model","volume":"27","author":"Ouyang","year":"2019","journal-title":"IEEE Trans Neural Syst Rehabil Eng"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1007\/s11517-022-02554-8","article-title":"Closed-loop sacral neuromodulation for bladder function using dorsal root ganglia sensory feedback in an anesthetized feline model","volume":"60","author":"Ouyang","year":"2022","journal-title":"Med Biol Eng Comput"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1177\/09544119231172272","article-title":"Automated closed-loop stimulation to inhibit neurogenic bladder overactivity","volume":"238","author":"Majerus","year":"2024","journal-title":"Proc Inst Mech Eng H"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1007\/s11282-015-0227-3","article-title":"Detection of Schistosoma eggs using an AI-based deep learning model on urinary bladder histopathology images","volume":"35","author":"Shams","year":"2025","journal-title":"J Coll Physicians Surg Pak"},{"key":"B34","doi-asserted-by":"publisher","first-page":"382","DOI":"10.1186\/s40001-025-02603-6","article-title":"An analytic research and review of the literature on practice of artificial intelligence in healthcare","volume":"30","author":"Mizna","year":"2025","journal-title":"Eur J Med Res"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.21037\/atm-25-61","article-title":"Enhancing home rehabilitation through AI-driven virtual assistants: a narrative review","volume":"13","author":"Olawade","year":"2025","journal-title":"Ann Transl Med"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1016\/s1470-2045(24)00220-1","article-title":"Artificial intelligence and radiologists in prostate cancer detection on MRI (PI-CAI): an international, paired, non-inferiority, confirmatory study","volume":"25","author":"Saha","year":"2024","journal-title":"Lancet Oncol"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2024.1487676","article-title":"Artificial intelligence application in the diagnosis and treatment of bladder cancer: advance, challenges, and opportunities","volume":"14","author":"Ma","year":"2024","journal-title":"Front Oncol"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1016\/j.ucl.2017.04.004","article-title":"Surveillance strategies for neurogenic lower urinary tract dysfunction","volume":"44","author":"Vince","year":"2017","journal-title":"Urol Clin North Am"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1002\/nau.25490","article-title":"Applications of machine learning in urodynamics: a narrative review","volume":"43","author":"Liu","year":"2024","journal-title":"Neurourol Urodyn"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1002\/nau.23501","article-title":"Value of urodynamic findings in predicting upper urinary tract damage in neuro-urological patients: a systematic review","volume":"37","author":"Musco","year":"2018","journal-title":"Neurourol Urodyn"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1038\/sc.2014.224","article-title":"Urodynamic or video-urodynamic assessment in patients with spinal cord injury: this is not a question","volume":"53","author":"Wollner","year":"2015","journal-title":"Spinal Cord"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1097\/spv.0000000000000754","article-title":"Low interrater reliability of videourodynamic diagnosis of detrusor external sphincter dyssynergia","volume":"27","author":"Miller","year":"2021","journal-title":"Female Pelvic Med Reconstr Surg"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.5213\/inj.2448430.215","article-title":"Real-time typical urodynamic signal recognition system using deep learning","volume":"29","author":"Liu","year":"2025","journal-title":"Int Neurourol J"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1002\/nau.25665","article-title":"Deep learning and numerical analysis for bladder outflow obstruction and detrusor underactivity diagnosis in men: a novel urodynamic evaluation scheme","volume":"44","author":"Mei","year":"2025","journal-title":"Neurourol Urodyn"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1111\/bju.70205","article-title":"Artificial intelligence in urology training: practical benefits and real-world limits","volume":"137","author":"Katsimperis","year":"2026","journal-title":"BJU Int"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1097\/ju.0000000000002235","article-title":"The\u00a0AUA\/SUFU guideline on adult neurogenic lower urinary tract dysfunction: diagnosis and evaluation","volume":"206","author":"Ginsberg","year":"2021","journal-title":"J Urol"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines11061748","article-title":"Urodynamics are essential to predict the risk for upper urinary tract damage after acute spinal cord injury","volume":"11","author":"Birkhauser","year":"2023","journal-title":"Biomedicines"},{"key":"B48","doi-asserted-by":"publisher","first-page":"1","DOI":"10.12968\/hmed.2025.0227","article-title":"Multivariate logistic regression analysis of risk factors and clinical countermeasures of neurogenic bladder after spinal cord injury","volume":"86","author":"Yang","year":"2025","journal-title":"Br J Hosp Med (Lond)"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmedinf.2025.106143","article-title":"Machine learning prediction of multidrug-resistant urinary tract infections in brain and spinal cord injury patients: a dual-center validation study","volume":"206","author":"Lee","year":"2026","journal-title":"Int J Med Inform"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1097\/ju.0000000000003984","article-title":"Identifying bladder phenotypes after spinal cord injury with unsupervised machine learning: a new way to examine urinary symptoms and quality of life","volume":"212","author":"Welk","year":"2024","journal-title":"J Urol"},{"key":"B51","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1038\/s41394-024-00680-z","article-title":"Squamous cell carcinoma of the urinary bladder in patients with chronic spinal cord injury: a case series","volume":"10","author":"Levien","year":"2024","journal-title":"Spinal Cord Ser cases"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djab179","article-title":"An artificial intelligence system for the detection of bladder cancer via cystoscopy: a multicenter diagnostic study","volume":"114","author":"Wu","year":"2022","journal-title":"J Natl Cancer Inst"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.1097\/00005392-199602000-00030","article-title":"Silent autonomic dysreflexia during voiding in men with spinal cord injuries","volume":"155","author":"Linsenmeyer","year":"1996","journal-title":"J Urol"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0001109888.05591.7e.04","article-title":"A wearable optical system for monitoring neurogenic bladder: tracking volume and pressure as a means of lessening the risk of incontinence and autonomic dysreflexia following spinal cord injury","volume":"213","author":"Stothers","year":"2025","journal-title":"J Urol"},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.1007\/s44258-025-00058-2","article-title":"Close-loop therapy with continuous sensing and on-demand drug delivery in the bladder","volume":"3","author":"Xiao","year":"2025","journal-title":"Med-X"},{"key":"B56","doi-asserted-by":"publisher","DOI":"10.2196\/49236","article-title":"Comparing\u00a0digital to conventional physical therapy for chronic shoulder pain:\u00a0randomized controlled trial","volume":"25","author":"Pak","year":"2023","journal-title":"J Med Internet Res"},{"key":"B57","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1007\/s11701-023-01801-w","article-title":"Advancements in robotic surgery: innovations, challenges and future prospects","volume":"18","author":"Chatterjee","year":"2024","journal-title":"J Robot Surg"},{"key":"B58","doi-asserted-by":"publisher","DOI":"10.1111\/bju.12072","article-title":"Robot-assisted laparoscopic artificial urinary sphincter insertion in men with neurogenic stress urinary incontinence","volume":"111","author":"Yates","year":"2013","journal-title":"BJU Int"},{"key":"B59","doi-asserted-by":"publisher","DOI":"10.1111\/bju.70192","article-title":"Legal and ethical considerations of artificial intelligence for trainees","volume":"137","author":"Fuligni","year":"2026","journal-title":"BJU Int"},{"key":"B60","doi-asserted-by":"publisher","DOI":"10.3171\/2025.12.spine251083","article-title":"The evolving landscape of spinal cord injury: a tale of 3 decades","volume":"45","author":"Quddusi","year":"2026","journal-title":"J Neurosurg Spine"},{"key":"B61","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s11934-023-01185-2","article-title":"Exploring the ethical, legal, and social implications of ChatGPT in urology","volume":"25","author":"Adhikari","year":"2024","journal-title":"Curr Urol Rep"}],"updated-by":[{"DOI":"10.3389\/fruro.2026.1962187","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000}}],"container-title":["Frontiers in Urology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fruro.2026.1931923\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T11:19:22Z","timestamp":1787224762000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fruro.2026.1931923\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,7]]},"references-count":61,"alternative-id":["10.3389\/fruro.2026.1931923"],"URL":"https:\/\/doi.org\/10.3389\/fruro.2026.1931923","relation":{},"ISSN":["2673-9828"],"issn-type":[{"value":"2673-9828","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,7]]},"article-number":"1931923"}}