排尿障害の基礎

Overview of the lower urinary tract dysfunction

　現在，排尿困難・尿閉を“排尿障害”，尿意切迫・頻尿・尿失禁を“蓄尿障害”と定めたうえで，これらを“下部尿路機能障害”と総称する．これらの病因と発症メカニズムは明確に区別され，実地臨床と基礎研究が進められている．下部尿路機能障害によって出現する自覚症状を“下部尿路症状”と呼ぶ．この中には，蓄尿症状，排尿症状，排尿後症状が含まれる．蓄尿症状を主とする過活動膀胱と腹圧性尿失禁，蓄尿症状に加え，膀胱痛を伴う間質性膀胱炎，蓄尿症状と排尿症状を併せもつことがある下部尿路閉塞，睡眠障害と密接な関係にある夜間頻尿は，生活の質を著しく低下することから積極的な治療の対象となる．

LUTD (lower urinary tract dysfunction) consists of ①voiding dysfunction including voiding disturbance and urinary retention and ②storage dysfunction including urgency, urinary frequency and incontinence.　Pathogenesis and participating mechanisms involved in the former dysfunction are differentiated from those in the latter, and clinical practices and basic research are conducted in consideration of the properties of each dysfunction.　LUTS (lower urinary tract symptoms) defined from the perspective of individuals with LUTD are divided into three groups:storage, voiding and post micturition symptoms.　LUTS caused by LUTD or associated diseases such as interstitial cystitis, bladder outlet obstruction and nocturia are bothersome and increase complaints concerning quality of life, and thus need to be treated.