Influence of the autonomic nervous system on the clinical course of overactive bladder

Abstract

Overactive bladder (OB) is a disease which is very easily diagnosed, but presents considerable difficulties in the choice of treatment mode. At present the specialists turn their attention to this syndrome due to a wide spread of the disease, its negative impact on quality of life, social and economic importance. Pathogenesis of OB is complex. Thus, under conditions of urothelium atrophy which takes place because of estrogen deficiency in postmenopausal women, in violation of its GAG protective layer, barrier function of urothelium are violated, which leads to its damage. The appearence of urination disorder symptoms are associated with the fact that atrophic mucosa of urethra and triangle of bladder are hypersensitive to even minimal portions of urine. Aging process also play a role in OB development including lowering ability of tissues to repair, their elasticity reduction, increased apoptosis and cell atrophy, degeneration of nerve endings, smooth muscle tone change, deterioration of urothelium and its GAG protective layer. It can be a result of manifestation of bladder outlet obstruction that causes OB symptoms in men suffering from benign hyperplasia, prostate cancer and chronic prostatitis.