Neurology and the Bladder: How to Assess and Manage Neurogenic Bladder Dysfunction, with Particular References to the Neural Control of Micturition Ryuji Sakakibara 1 , Fuyuki Tateno 1 , Masahiko Kishi 1 , Yohei Tsuyusaki 1 , Tomoyuki Uchiyama 2 , Tatsuya Yamamoto 3 1Neurology, Internal Medicine, Sakura Medical Center, Toho University 2Continence Center, Dokkyo Medical College 3Neurology, Chiba University Keyword: 神経因性膀胱 , 過活動膀胱 , 残尿 , 自律神経障害 , ムスカリン性アセチルコリン受容体 , neurogenic bladder dysfunction , overactive bladder , post-void residual , autonomic dysfunction , muscarinic acetylcholine receptor pp.527-537
Published Date 2014/5/1
DOI https://doi.org/10.11477/mf.1416101790
  • Abstract
  • Look Inside
  • Reference


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.

Copyright © 2014, Igaku-Shoin Ltd. All rights reserved.


電子版ISSN 1344-8129 印刷版ISSN 1881-6096 医学書院