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Shared Pathophysiology of Detrusor Overactivity and Detrusor Underactivity

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

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.

Recent Findings

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.

Summary

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.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major Importance

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  1. Department of Urology, Medstar Georgetown University Hospital, 3800 Reservoir Road, NW - 1 PHC, Washington, DC, 20007, USA

    Henry Collier Wright & Elizabeth Timbrook Brown

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Correspondence to Elizabeth Timbrook Brown.

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Dr. Wright and Dr. Brown declare that they have no conflict of interest.

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

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Wright, H.C., Brown, E.T. Shared Pathophysiology of Detrusor Overactivity and Detrusor Underactivity. Curr Bladder Dysfunct Rep 13, 267–273 (2018). https://doi.org/10.1007/s11884-018-0490-3

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