Recent advances in basic science for overactive bladder

Vivek Kumar*, Rebecca L. Cross, Russell Chess-Williams, Christopher R. Chapple

*Corresponding author for this work

Research output: Contribution to journalReview articleResearchpeer-review

52 Citations (Scopus)

Abstract

Purpose of review: Detrusor overactivity is a relatively common yet embarrassing symptom complex with significant impact on quality of life. The mainstay of current pharmacological treatment involves the use of muscarinic receptor antagonists, but their therapeutic effectiveness is limited by a combination of limited efficacy and troublesome side effects and has recently been challenged by Herbison et al. Recognition of the limitations of existing therapy has started the search for pharmacotherapeutic agents acting on alternative pathways underlying detrusor overactivity with the intention of improving storage symptoms of urgency, frequency and urge incontinence. Recent findings: Recent research has suggested that several transmitters may modulate bladder storage. However, no agents currently available, acting via mechanisms other than muscarinic receptors have entered clinical practice so far. It is clear that far from being a passive container for urine, the urothelium is a crucial area within the bladder wall and its functions are complex and only now beginning to be appreciated. The release of several neurotransmitters from urothelium in response to distension and its action on receptors on sensory neurons is being increasingly recognized. The role for this afferent stimulation on the micturition reflex is gradually gaining importance in the pathophysiology of detrusor overactivity. Summary: In this article, the recent developments in basic science related to the pathogenesis and pharmacological basis for future drug targets for effective management of overactive bladder are discussed.

Original languageEnglish
Pages (from-to)222-226
Number of pages5
JournalCurrent Opinion in Urology
Volume15
Issue number4
DOIs
Publication statusPublished - Jul 2005
Externally publishedYes

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