Smith PP. Pathophysiology of the Underactive Bladder: Evolving New Concepts.
CURRENT BLADDER DYSFUNCTION REPORTS 2017;
12:35-41. [PMID:
28740567 DOI:
10.1007/s11884-017-0407-6]
[Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW
Underactive Bladder (UAB) is an emerging concept of voiding dysfunction, building on a tradition of often overlapping and confusing terminologies describing the patient experience, urodynamic function, and pathophysiology. This confusion of symptoms with function with pathology has hampered development of an effective disease model.
RECENT FINDINGS
As with other urinary symptoms, the relationship of voiding symptoms to urodynamic dysfunction is variable. Efforts are underway to formally define UAB as a collection of symptoms related to voiding. Defined as voiding symptoms, UAB cannot be reliably linked to detrusor underactivity (DU) nor to detrusor weakness.
SUMMARY
Progress will be made by characterizing the functional disorders underlying UAB symptoms, examining the biology of these linkages, re-conceptualizing urinary control as one part of a more global biologic adaptive physiology, and determining the relationships of central and peripheral pathologies leading to disrupted control mechanisms.
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