Fibrosis, the excessive deposition of fibrous connective tissue, is a common feature of lower urinary tract (LUT) pathologies. It occurs not just in the bladder but also in the outflow tract and in associated tissues such as the prostate gland. The consequences of fibrosis can range from alterations to the physical properties of the LUT, loss of primary contractile tissues, to the secretion of cytokines that themselves impact on LUT function. This round table discussion will consider: under what conditions fibrosis becomes especially prevalent; how it affects overall LUT function; the cellular and tissue pathways whereby fibrosis occurs; and how it may be reversed to allow recovery of LUT function towards the normal phenotype. The panel consists of clinical and scientific experts who can each contribute to these questions.