Abstract
<title>Abstract</title> <p> <bold>Background</bold> Neurogenic lower urinary tract dysfunction is a frequent consequence of spinal cord injury (SCI), impairing bladder storage and voiding and reducing quality of life. Current management strategies focus on symptom control rather than restoration of voiding. In this study, we assessed patient acceptability of Spinal Cord-Machine Interface designed to restore bladder sensation and allow volitional bladder emptying in patients with SCI. <bold>Methods</bold> Thirteen adults with SCI and neurogenic lower urinary tract dysfunction participated in focus groups. Following a standardized video describing the investigational device, discussions were audio-recorded, transcribed, and analyzed using reflexive thematic analysis. <bold>Results</bold> Six themes emerged: (1) the importance of altered lower urinary tract sensation; (2) dissatisfaction with current bladder management; (3) dissatisfaction with current bladder management strategies and Burden of Dependency; (4) significant urinary tract infection burden; (5) social disruption from catheter use; (6) perceived benefits for autonomy and dignity; and (7) concerns over procedural invasiveness, surgical risks, device longevity, and long-term management. <bold>Conclusions</bold> While the potential for restored volitional bladder control was valued, concerns over safety and durability influence acceptability. Integrating patient perspectives early in development may ensure alignment with user priorities. </p>