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Ätiologie und Pathogenese der Blasenüberaktivität

Etiology and pathogenesis of overactive bladder

  • Urologische Forschung
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Zusammenfassung

Der Symptomenkomplex „Überaktive Blase“ (ÜAB bzw. OAB) betrifft >10% der erwachsenen Bevölkerung. Die Ätiopathogenese ist multifaktoriell. Harnwegsinfekte, Blasentumore, Fremdkörper, stattgehabte Bestrahlung der Blase und intravesikale Chemoinstillation müssen zunächst ausgeschlossen werden. Oftmals liegt der OAB eine neurogene Schädigung zugrunde, welche zur Ausbildung einer Detrusorhyperaktivität führt. Aber auch primär nichtneurogene Veränderungen wie die Blasenauslassobstruktion oder weibliche Beckenbodendysfunktionen bzw. ligamentäre Lockerheiten mit Ausbildung einer Zystozele bzw. eines Genitalprolapses können wesentlich zur Entstehung der OAB beitragen. In der Folge sind Urothel, Suburothel, Detrusor und Blasenafferenzen an der Symptomentstehung beteiligt. Durchblutungsstörungen wurden bislang noch wenig beachtet. Diese sowie molekulare Veränderungen der Blasenafferenzen gilt es künftig detaillierter zu untersuchen.

Abstract

The symptom complex“overactive bladder” (OAB) affects more than 10% of adult individuals. The etiopathology is complex and multifactorial. Foremost, urinary tract infection, bladder cancer, foreign bodies, and history of radiation or intravesical instillation of chemotherapeutics must be excluded. In many cases, OAB is caused by neurogenic disorders that activate involuntary detrusor contractions (detrusor overactivity, DO). Also, non-neurogenic disorders such as bladder outlet obstruction or dysfunctions of the female pelvic floor/slack ligaments that affect the urothelium, suburothelium, detrusor and bladder afferents are substantially involved in the pathogenesis of OAB. Until now, circulatory disorders have not been adequately taken into consideration but seem to be another etiological factor that causes OAB. Henceforth, molecular changes of bladder afferents and circulatory disorders in patients suffering from OAB have to be investigated in more detail.

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Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehungen hin:

T. Bschleipfer: Vortragstätigkeit für die Firmen Astellas und Bayer Health Care/Bayer Vital GmbH.

F. Wagenlehner: finanzielle Beziehung zu den Firmen AstelIas, Bayer Vital, Calixa, MerLion, OM-Pharma, Janssen-Cilag, Johnson & Johnson, Pharmacia, Pierre Fabre, Rosen-Pharma, Sanofi-Aventis und Zambon.

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Authors and Affiliations

  1. Klinik und Poliklinik für Urologie, Kinderurologie und Andrologie, Universitätsklinikum Gießen und Marburg GmbH, Standort Gießen, Justus-Liebig-Universität Gießen, Rudolf-Buchheim-Straße 7, 35392, Gießen, Deutschland

    T. Bschleipfer F.E.B.U., F. Wagenlehner & W. Weidner

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  1. T. Bschleipfer F.E.B.U.
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  2. F. Wagenlehner
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  3. W. Weidner
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Correspondence to T. Bschleipfer F.E.B.U..

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Bschleipfer, T., Wagenlehner, F. & Weidner, W. Ätiologie und Pathogenese der Blasenüberaktivität. Urologe 50, 477–480 (2011). https://doi.org/10.1007/s00120-011-2522-x

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