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Key Points Interactions between brain-derived neurotrophic factor (BDNF) and glutamate receptors participate in regulation of lower urinary tract function BDNF-mediated glutamate signalling could have a role in the pharmacological mechanism of action of duloxetine BDNF helps to maintain the continence mechanism by facilitation of pudendal nerve restoration after injury during childbirth Both pudendal neuromodulation and onabotulinumtoxinA injection demonstrate a possible BDNF-related mechanism of action Manipulation of BDNF levels, by electrical stimulation or other indirect methods, is a potential therapeutic strategy in the management of lower urinary tract symptoms Abstract Urinary incontinence adversely affects quality of life and results in an increased financial burden for the elderly