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Impact of Autonomic Dysfunction on Lower Urinary Tract Symptoms

  • Reconstructed Bladder Function & Dysfunction (M Kaufman, Section Editor)
  • Published:
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Abstract

Purpose of Review

Normal bladder function involves complex interactions of the autonomic nervous system. Patients with autonomic disorders may experience lower urinary tract dysfunction due to disruption of the micturition pathways. In this article, we review relevant anatomy involved in the neural control of micturition and examine the impact of functional and structural autonomic disorders on the lower urinary tract.

Recent Findings

Depending on the etiology and localization of the autonomic disorder, patients with dysautonomias can experience a variety of urinary symptoms, including urinary hesitancy, urgency, and incontinence. Studies suggest a clinical association between diabetes and bladder dysfunction as a result of autonomic neuropathy. The majority of patients with lower urinary tract symptoms and multiple system atrophy or Parkinson’s disease has detrusor overactivity on urodynamic evaluation, reflecting that the voiding reflex is not inhibited by supraspinal control centers. Recent data also shows that alterations in the autonomic system may be involved in the pathogenesis of bladder pain syndrome and interstitial cystitis.

Summary

LUT dysfunction in patients with autonomic disorders can significantly affect quality of life and be difficult to treat, highlighting a need for continued research efforts in this area.

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Authors and Affiliations

  1. Department of Urologic Surgery, Vanderbilt University Medical Center, 1302A Medical Center North, Nashville, TN, 37232, USA

    Casey G. Kowalik, Joshua A. Cohn, Melissa R. Kaufman, W. Stuart Reynolds, Roger R. Dmochowski & Douglas F. Milam

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  1. Casey G. Kowalik
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  2. Joshua A. Cohn
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  3. Melissa R. Kaufman
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  4. W. Stuart Reynolds
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  5. Roger R. Dmochowski
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  6. Douglas F. Milam
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Corresponding author

Correspondence to Casey G. Kowalik.

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Conflict of Interest

Kowalik, Cohn, Reynolds, and Milam declare no conflicts of interests.

Kaufman declares they are a consultant for Boston Scientific, Investigator for Cook Myosite.

Dmochowski declares they are a consultant for Medtronic and Allergan.

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.

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This article is part of the Topical Collection on Reconstructed Bladder Function & Dysfunction

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Kowalik, C.G., Cohn, J.A., Kaufman, M.R. et al. Impact of Autonomic Dysfunction on Lower Urinary Tract Symptoms. Curr Bladder Dysfunct Rep 12, 273–279 (2017). https://doi.org/10.1007/s11884-017-0426-3

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  • DOI: https://doi.org/10.1007/s11884-017-0426-3

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