By Christopher R. Chapple, Alan J. Wein, Nadir I. Osman
The box of underactive bladder is a poorly acknowledged but very important medical situation, affecting as much as a 3rd of sufferers over sixty five. during this ebook, the authors examine the sphere of underactive bladder and its presentation, scientific analysis, strength etiopathogenesis and treatment.
While the editors tackle loads of heritage info, they basically determine that many barriers nonetheless exist to medical analysis and urodynamic evaluate, and specifically a dearth of acceptable healing procedures. This complicated situation should be well-known and pointed out within the regimen review and scientific administration of patients.
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Extra info for Underactive Bladder
16] used electromotive administration of intravesical bethanechol and could identify patients with an atonic bladder and adequate residual detrusor muscle function. They concluded that patients who do not respond to the electromotive administration of bethanechol do not benefit from oral bethanechol and are candidates for catheterization. To combine bladder contraction and outflow relaxation, Hindley et al. , in a placebo-controlled study, treated 19 patients with DUA with a combination of intravesical PGE2 and oral bethanechol.
2004), monotherapy with bethanechol seemed to be marginal, and whether the combination therapy really is better than monotherapy with α-AR antagonist has to be confirmed in appropriately designed studies. , prostaglandin (PG) E2 can both increase detrusor contraction and relax the urethra in humans . PGE2 does not only stimulate detrusor contraction directly, but may also enhance the efficacy of other contraction-mediating transmitters. In addition, PGE2 can increase afferent activity both by stimulating the urothelial and myogenic pathways [37, 38].
London: Springer; 2006. 6. Thomas AW, Cannon A, Bartlett E, Ellis-Jones J, Abrams P. The natural history of lower urinary tract dysfunction in men: minimum 10-year urodynamic follow-up of untreated detrusor underactivity. BJU Int. 2005;96:1295–300. 7. Parys BT, Machin DG, Woolfenden KA, Parsons KF. Chronic urinary retention–a sensory problem? Br J Urol. 1988;62:546–9. 8. Massey JA, Abrams PH. Obstructed voiding in the female. Br J Urol. 1988;61:36–9. 9. Resnick NM, Yalla SV. Detrusor hyperactivity with impaired contractile function.
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