**9. Conclusions**

Managing NLUTDs in patients with chronic SCI requires deliberating over several aspects of the condition, such as the level and severity of SCI, hand dexterity and walking ability, vocation and daily routine of the patient, abdominal muscle function and bladder sensation, clinical symptoms of voiding difficulty and urinary incontinence, bladder pressure, and upper urinary tract condition. Clinicians must review the pros and cons of the BoNT-A therapy with the patients before deciding on the site of injection (detrusor and/or urethral sphincter) to address their bladder emptying or storage problems. Regular urodynamic study and LUTS evaluation are essential for optimal adjustment of dosage and duration between BoNT-A injections. BoNT-A injections are a powerful tool for treating refractory NLUTDs in SCI patients. Despite the potential AEs, the effects typically wear off after six to nine months. Compared to other invasive treatments, the reversibility of BoNT-A injections is one of its major advantages.

**Author Contributions:** Methodology, T.-C.Y. and B.-J.C.; validation, E.M. and Y.-C.L.; investigation, Y.-L.K.; writing—original draft preparation, P.-C.C. and K.-H.L.; writing—review and editing, H.-C.K.; supervision, Y.-C.K.; project administration, W.-C.L. and C.-H.L. All authors have read and agreed to the published version of the manuscript.

**Funding:** This research was funded by the Buddhist Tzu Chi Medical Foundation grants TCMF-SP-108-01 and TCMF-MP-110-03-01.

**Institutional Review Board Statement:** Not applicable.

**Informed Consent Statement:** Not applicable.

**Data Availability Statement:** The data presented in this study are available this article.

**Conflicts of Interest:** The authors declare no conflict of interest.
