Shared Pathophysiology of Detrusor Overactivity and Detrusor Underactivity
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Purpose of Review
Detrusor overactivity (DO) and the associated symptom complex of overactive bladder (OAB) is well-studied with many treatment options. In contrast, detrusor underactivity (DU) and its associated symptom complex, underactive bladder (UAB), is poorly understood. Researchers have proposed explanations that link OAB and UAB with a common pathophysiology. The purpose of this review is to examine concepts and recent underlying research supporting a shared pathophysiology of DO and DU.
In 2014, Dr. Michael Chancellor proposed “The Overactive Bladder Progression to Underactive Bladder Hypothesis.” Since then, researchers have conducted several animal and human studies to examine the pathophysiology of OAB and UAB. These studies, which highlight this shared pathophysiology, can be categorized broadly into neurogenic, myogenic, urothelial dysfunction, and idiopathic etiologies. Autonomous bladder micromotions are another proposed mechanism of shared OAB and UAB pathophysiology.
UAB is poorly understood in comparison to OAB, yet the concept of a shared pathophysiology could shed light into future research, technology, and pharmacologic interventions to adequately manage patients with these conditions.
KeywordsUnderactive bladder Overactive bladder Detrusor overactivity Detrusor underactivity Pathophysiology
Compliance with Ethical Standards
Conflict of Interest
Dr. Wright and Dr. Brown declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major Importance
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