Bladder dysfunctions are one of the most common autonomic dysfunctions.
Among these, overactive bladder (OAB) (urinary urgency and frequency) significantly worsens the quality of life in patients, and large post-void residual/urinary retention causes urinary tract infections, kidney dysfunction, and may affect morbidity. In the present paper, we discuss the neural control of micturition, with particular reference to acetylcholine. Further, we discuss appropriate management of bladder dysfunction in diabetic neuropathy (a common cause of urinary retention), Alzheimer's disease, and white matter lesions (common causes of OAB in the elderly). For OAB, anti-cholinergics are the mainstay, whereas for large post-void residual/retention, alpha-blockers, cholinergic agents and clean, intermittent self-catheterization are the treatments of choice. Treatment of bladder dysfunctions is an important target for maximizing patients' quality of life.
Written by:
Sakakibara R, Tateno F, Kishi M, Tsuyusaki Y, Uchiyama T, Yamamoto T. Are you the author?
Neurology, Internal Medicine, Sakura Medical Center, Toho University.
Reference: Brain Nerve. 2014 May;66(5):527-37.
PubMed Abstract
PMID: 24807369
Article in Japanese.
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