Pathophysiological mechanisms in detrusor underactivity: Novel experimental findings

Luis Vale, Filipa Jesus, Tom Marcelissen, Malte Rieken, Bogdan Geavlete, Mohammad Sajjad Rahnama'i, Frank Martens, Francisco Cruz, Tiago Antunes-Lopes*, EAU Young Academic Urologists Functional Urology Working Group

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

6 Citations (Web of Science)

Abstract

Underactive bladder (UAB) is a multifactorial symptom complex often related to detrusor underactivity (DU). Although recognized as a common cause of lower urinary tract symptoms and with significant effects on quality of life, UAB/DU is largely underresearched. Herein, we review up-to-date knowledge on the pathophysiological mechanisms of UAB/DU, with an emphasis on the relationship between UAB and bladder outlet obstruction (BOO). Original articles and reviews concerning UAB/DU were identified through a search of the PubMed/Medline and Scopus databases. DU can result from several pathological mechanisms, which can be categorized as idiopathic, neurogenic, myogenic, or functional. The main etiological factors of UAB/DU are aging, diabetes mellitus, neurogenic disorders, and BOO. Although conventional models focus primarily on efferent nerve and myogenic mechanisms, contemporary views highlight the importance of the afferent pathway. Specifically, recent findings in BOO showed that afferent dysfunction, such as altered expression of muscarinic and purinergic P2X(3) receptors or diminished urothelial ATP may play a role in the initial and reversible stages of DU, with potential diagnostic and therapeutic implications.

Original languageEnglish
Pages (from-to)92-98
Number of pages7
JournalLUTS-Lower Urinary Tract Symptoms
Volume11
Issue number3
DOIs
Publication statusPublished - May 2019

Keywords

  • bladder outlet obstruction
  • detrusor underactivity
  • lower urinary tract symptoms
  • pathophysiology
  • BLADDER OUTLET OBSTRUCTION
  • GERIATRIC VOIDING DYSFUNCTION
  • URINARY-TRACT DYSFUNCTION
  • TERM CALORIC RESTRICTION
  • STRUCTURAL BASIS
  • COMMON
  • MODEL
  • CONTRACTILITY
  • EPIDEMIOLOGY
  • INCONTINENCE

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