Pathophysiology: The varieties of bladder overactivity
Pathophysiology: The varieties of bladder overactivity
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DOI：
10.1016/s0090-4295(02)01788-0
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发表时间：
2002-11-01
期刊：
影响因子：
2.1
通讯作者：
Mostwin, JL
中科院分区：
文献类型：
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作者：
Mostwin, JL
膀胱过度活动症（OAB）是目前临床医学中最常用的术语，用于描述伴有或不伴有尿失禁的复杂下尿路症状（LUTS）。症状通常包括尿急、尿频、尿急、排便困难或不完全排空，偶尔还有疼痛。膀胱过度活动的原因包括神经系统疾病或损伤、膀胱出口梗阻、尿道无力、老年患者的逼尿肌活动过度和收缩力受损、新的排尿反射的出现和所谓的特发性膀胱过度活动。大多数临床医生认为，OAB症状的有效治疗应通过对患者这些影响因素的基本评估来指导。然而，它是不是在所有确定的结果显着改善诊断精度。这部分是因为在各种常见的下尿路疾病中普遍存在LUTS：压力性尿失禁，出口梗阻和神经疾病或损伤。普遍存在的下尿路症状意味着它们是由共同的机制引起的，至少在理论上，它们可以接受单一形式的有效治疗。相反，LUTS的种类和数量有限，下尿路结构在中枢神经系统中的代表性有限，这可能意味着几种不同的原因产生类似的症状，但这些症状不适合单一形式的有效治疗。未来的研究方向应该记住每一种可能的解释，因为关于下尿路功能的新知识和可能的干预措施不断出现。(C)2002年，Elsevier Science Inc.
Overactive bladder (OAB) is the most common term currently used in clinical medicine to describe a complex of lower urinary tract symptoms (LUTS) with or without incontinence. The symptoms usually include urgency, frequency, nocturia, troublesome or incomplete emptying, and, occasionally, pain. Causes of bladder overactivity include neurologic illness or injury, bladder outlet obstruction, urethral weakness, detrusor hyperactivity and impaired contractility in elderly patients, emergence of new voiding reflexes, and so-called idiopathic bladder overactivity. Most clinicians agree that effective treatment for OAB symptoms should be guided by a basic assessment of patients for these contributing factors. However, it is not at all certain that outcomes are significantly improved by diagnostic precision. This is in part because of the ubiquity of LUTS in the setting of the various common lower urinary tract disorders: stress incontinence, outlet obstruction, and neurologic illness or injury. The ubiquity of LUTS would imply that they are caused by common mechanisms and, theoretically at least, would be amenable to a single form of effective therapy. Conversely, the limited kinds and number of LUTS and the limited representation of lower urinary tract structures in the central nervous system may mean that several different causes produce similar symptoms, but these are not amenable to a single form of effective therapy. Future research directions should keep each possible explanation in mind as new knowledge about lower urinary tract function and possible intervention continues to emerge. (C) 2002, Elsevier Science Inc.