Damage to lower genitourinary (GU) organs, which can lead to organ dysfunction and/or infertility, poses a significant threat to individual health and quality of life. Polysaccharide-based delivery systems for biologically active therapeutics have emerged as promising strategies for regenerative treatment. However, several challenges remain in achieving site-specific delivery with optimal bioactivity, stability, and sustained release for long-term therapeutic efficacy.This review highlights recent advancements in delivery system design, including manufacturing technologies, bioactive loading strategies, and innovative therapeutic applications aimed at enhancing clinical outcomes. We explore how these developments are being applied to regenerative therapies targeting lower GU injuries and dysfunctions.Notably, the integration of smart delivery technologies, tailored biomaterials, and bio responsive platforms has led to the development of more precise, multifunctional, and intelligent systems. Encouraging results have been reported both in clinical applications and preclinical in vivo models. Furthermore, the continuous evolution of biomedical materials, therapeutic agents, and 3D printing techniques, combined with emerging engineering approaches, offers a promising future for the management and repair of lower GU tract disorders.