Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.736
5-Year Impact Factor – 2.135
Index Copernicus  – 168.52
MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

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Advances in Clinical and Experimental Medicine

2011, vol. 20, nr 2, March-April, p. 119–129

Publication type: editorial article

Language: English

Overactive Bladder – Current Definition and Basic Pathophysiology Concepts

Współczesna definicja i patofizjologia pęcherza nadaktywnego

Łukasz Dobrek1,, Kajetan Juszczak1,2,, Marek Wyczółkowski2,, Piotr Jan Thor1,

1 Department of Pathophysiology, Jagiellonian University Medical College, Kraków, Poland

2 Department of Urology, Memorial Rydygier Hospital, Kraków, Poland

Abstract

Overactive bladder (OAB) is a clinical entity with a general prevalence of about 17% in adults, characterized by urgency with or without incontinence, usually with increased daytime frequency and nocturia. The pathophysiology of OAB is complex, involving disturbances of both the central nervous system (decreased suprapontine inhibition of micturition) and the peripheral nervous system (damage of the axonal paths in the spinal cord, loss of peripheral inhibition or enhancement of excitatory neurotransmission in the voiding reflex) as well as myogenic disturbances (structural and ultrastructural changes in the detrusor smooth muscle). The article briefly reviews the anatomy and physiology of the lower urinary tract and the current definitions and terminology used in the literature on OAB, with a particular focus on theories explaining the pathomechanism of the syndrome.

Streszczenie

Nadaktywny pęcherz moczowy (OAB) jest zaburzeniem występującym u około 17% dorosłej populacji, charakteryzującym się nagłą potrzebą oddania moczu wraz z nietrzymaniem moczu lub bez niego, przebiegającym zwykle ze zwiększoną częstotliwością mikcji i nokturią. Patogeneza OAB jest złożona, obejmuje zaburzenia o charakterze neurogennym – uszkodzenie centralnych ośrodków nerwowych regulujących czynność pęcherza oraz jego aferentnego i eferentnego unerwienia oraz zaburzenia o charakterze miogennym ściany pęcherza. W niniejszym artykule krótko omówiono anatomiczne i fizjologiczne aspekty dolnych dróg moczowych, obecną definicję i epidemiologię OAB wraz z patofizjologicznymi koncepcjami rozwoju tego zespołu.

Key words

lower urinary tract (LUT), overactive bladder (OAB), OAB pathophysiology

Słowa kluczowe

dolne drogi moczowe (LUT), nadaktywny pęcherz moczowy (OAB), patofizjologia OAB

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