Mild photothermal therapy ameliorates neurogenic bladder after sacral spinal cord injury via multi-target effects.

Neurogenic bladder (NB) is a devastating complication following sacral spinal cord injury (SSCI), often leading to urinary incontinence, recurrent infections, and progressive renal dysfunction, which severely impair patients' quality of life and survival. Current therapeutic options remain largely palliative and fail to reverse the underlying neurogenic pathology. This study employed mild photothermal therapy (MPTT) to treat SSCI-induced NB in rats and systematically investigated its efficacy and mechanisms. Results showed that MPTT effectively improved bladder morphology and urodynamic parameters, with more significant effects observed in early intervention. Mechanistically, MPTT inhibited bladder fibrosis, alleviated chronic inflammation, restored the balance between cell proliferation and apoptosis, promoted functional angiogenesis, and repaired structural damage and function of bladder nerve fibers. MPTT ameliorates SSCI-NB function through multi-target effects, and its time-dependent therapeutic efficacy suggests the necessity of early and repeated interventions, providing experimental and theoretical evidence for new NB treatment strategies.