Pathophysiology of refractory overactive bladder

doi:10.1111/luts.12262

Review

. 2019 Sep;11(4):177-181.

doi: 10.1111/luts.12262. Epub 2019 Mar 22.

Pathophysiology of refractory overactive bladder

Li-Chen Chen^{1

2}, Hann-Chorng Kuo³

Affiliations

¹ Department of Urology, Mackay Memorial Hospital, Taipei, Taiwan.
² Department of Medicine, Mackay Medical College, Taipei, Taiwan.
³ Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan.

PMID: 30900373
DOI: 10.1111/luts.12262

Review

Pathophysiology of refractory overactive bladder

Li-Chen Chen et al. Low Urin Tract Symptoms. 2019 Sep.

. 2019 Sep;11(4):177-181.

doi: 10.1111/luts.12262. Epub 2019 Mar 22.

Authors

Li-Chen Chen^{1

2}, Hann-Chorng Kuo³

Affiliations

¹ Department of Urology, Mackay Memorial Hospital, Taipei, Taiwan.
² Department of Medicine, Mackay Medical College, Taipei, Taiwan.
³ Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan.

PMID: 30900373
DOI: 10.1111/luts.12262

Abstract

Overactive bladder (OAB) is a common condition. The International Continence Society defines OAB as a symptom complex characterized by urgency with or without urge incontinence, usually with frequency and nocturia. The first-line treatment for OAB includes behavioral therapy, such as caffeine reduction, fluid intake modification, weight reduction, bladder training, and pelvic floor muscle training, as well as treatment with antimuscarinic or β₃ -adrenoceptor agonist medications. However, less than half of all cases achieve satisfactory outcomes following first-line treatment. Second-line therapy considered if satisfactory responses are not achieved after 8 to 12 weeks treatment with first-line therapy include intradetrusor botulinum toxin injection, neuromodulation, and surgical treatment. Patients with refractory OAB may have more severe symptoms or underlying pathophysiologies that were not resolved by the initial medication. The pathophysiologies of refractory OAB include occult neurogenic bladder, undetected bladder outlet obstruction, urethral-related OAB, urothelial dysfunction with aging, chronic bladder ischemia, chronic bladder inflammation, central sensitization, and autonomic dysfunction. This article discusses the possible pathophysiologies of refractory OAB.

Keywords: overactive bladder; pathophysiology; refractory overactive bladder.

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References

REFERENCES

1. Stewart WF, Van Rooyen JB, Cundiff GW, et al. Prevalence and burden of overactive bladder in the United States. World J Urol. 2003;20:327-336.
1. Chuang YC, Liu SP, Lee KS, et al. Prevalence of overactive bladder in China, Taiwan and South Korea: results from a cross-sectional, population-based study. Low Urin Tract Symptoms. 2019;11:48-55.
1. Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn. 2002;21:167-178.
1. Yamaguchi O, Honda K, Nomiya M, et al. Defining overactive bladder as hypersensitivity. Neurourol Urodyn. 2007;26(Suppl):904-907.
1. Nabi G, Cody JD, Ellis G, Herbison P, Hay-Smith J. Anticholinergic drugs versus placebo for overactive bladder syndrome in adults. Cochrane Database Syst Rev. 2006;4:CD003781.

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[1] Stewart WF, Van Rooyen JB, Cundiff GW, et al. Prevalence and burden of overactive bladder in the United States. World J Urol. 2003;20:327-336.

[2] Stewart WF, Van Rooyen JB, Cundiff GW, et al. Prevalence and burden of overactive bladder in the United States. World J Urol. 2003;20:327-336.

[3] Chuang YC, Liu SP, Lee KS, et al. Prevalence of overactive bladder in China, Taiwan and South Korea: results from a cross-sectional, population-based study. Low Urin Tract Symptoms. 2019;11:48-55.

[4] Chuang YC, Liu SP, Lee KS, et al. Prevalence of overactive bladder in China, Taiwan and South Korea: results from a cross-sectional, population-based study. Low Urin Tract Symptoms. 2019;11:48-55.

[5] Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn. 2002;21:167-178.

[6] Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn. 2002;21:167-178.

[7] Yamaguchi O, Honda K, Nomiya M, et al. Defining overactive bladder as hypersensitivity. Neurourol Urodyn. 2007;26(Suppl):904-907.

[8] Yamaguchi O, Honda K, Nomiya M, et al. Defining overactive bladder as hypersensitivity. Neurourol Urodyn. 2007;26(Suppl):904-907.

[9] Nabi G, Cody JD, Ellis G, Herbison P, Hay-Smith J. Anticholinergic drugs versus placebo for overactive bladder syndrome in adults. Cochrane Database Syst Rev. 2006;4:CD003781.

[10] Nabi G, Cody JD, Ellis G, Herbison P, Hay-Smith J. Anticholinergic drugs versus placebo for overactive bladder syndrome in adults. Cochrane Database Syst Rev. 2006;4:CD003781.

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Pathophysiology of refractory overactive bladder

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Pathophysiology of refractory overactive bladder

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