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Pathophysiology and Associations of Underactive Bladder

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Underactive Bladder

Abstract

Underactive bladder (UAB; symptom diagnosis) and detrusor underactivity (DUA; urodynamic diagnosis) are common, aging-related, multifactorial conditions. Aging per se may cause changes in bladder structure and function, but other concomitant disorders such as, bladder outflow obstruction, diabetes mellitus, neurogenic disorders, and ischemic bladder dysfunction, are often associated with UAB/DUA and may aggravate aging-induced reduction in bladder function. Impaired detrusor contractility has been regarded as a major etiologic factor of UAB/DUA. However, disturbances of bladder sensory afferents and the central nervous system control of micturition, and changes in efferent neurotransmission may be as important. Recent studies suggest that chronic bladder ischemia and resultant oxidative stress may cause detrusor overactivity progressing to DUA and inability to empty the bladder. In order to understand UAB/DUA, identification of the underlying cause(s) is necessary either by clinical symptoms or by urodynamics. Effective pharmacologic therapy is lacking, but combining individually designed standard therapy with optimized treatment of associated co-morbidities may lead to improved treatment results.

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Authors and Affiliations

  1. Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston Salem, NC, USA

    K. E. Andersson MD, PhD

  2. Clinical Medicine, Department of Obstetrics and Gynecology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK 8200, Aarhus N, Denmark

    K. E. Andersson MD, PhD

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  1. Urology, The Royal Hallamshire Hospital, Sheffield, United Kingdom

    Christopher R. Chapple

  2. West Pavilion, 3rd Floor, Urology, Perelman Center, Philadelphia, Pennsylvania, USA

    Alan J. Wein

  3. Specialty Registrar, The Royal Hallamshire Hospital, Sheffield, South Yorkshire, United Kingdom

    Nadir I. Osman

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Andersson, K.E. (2017). Pathophysiology and Associations of Underactive Bladder. In: Chapple, C., Wein, A., Osman, N. (eds) Underactive Bladder. Springer, Cham. https://doi.org/10.1007/978-3-319-43087-4_1

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