Abstract

Overactive bladder (OAB) is a common debilitating condition characterized by urgency symptoms with detrimental effects on the quality of life and survival. The exact etiology of OAB is still enigmatic, and none of therapeutic approaches seems curative. OAB is generally regarded as a separate syndrome, whereas in clinic, OAB symptoms could be found in numerous diseases of other non-urogenital systems, particularly nervous system. The OAB symptoms in neurological diseases are often poorly recognized and inadequately treated. This review provided a comprehensive overview of recent findings related to the neurogenic OAB symptoms. Relevant neurological diseases could be mainly divided into seven kinds as follows: multiple sclerosis and related neuroinflammatory disorders, Parkinson’s diseases, multiple system atrophy, spinal cord injury, dementia, peripheral neuropathy, and others. Concurrently, we also summarized the hypothetical reasonings and available animal models to elucidate the underlying mechanism of neurogenic OAB symptoms. This review highlighted the close association between OAB symptoms and neurological diseases and expanded the current knowledge of pathophysiological basis of OAB. This may increase the awareness of urological complaints in neurological disorders and inspire robust therapies with better outcomes.

Highlights

  • Overactive bladder (OAB) was defined as a storage symptom syndrome characterized by “urinary urgency, usually accompanied by frequency and nocturia, with or without urgency urinary incontinence, in the absence of urinary tract infection or other obvious pathology” (Abrams et al, 2002)

  • A comprehensive electronic literature search was conducted using the PubMed database to identify publications related to the neurological diseases with OAB symptoms

  • Another previous report estimated that highly up to 80% of patients with Parkinson’s disease (PD) may suffer from lower urinary tract symptoms (LUTS) (McDonald et al, 2017)

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Summary

Introduction

Overactive bladder (OAB) was defined as a storage symptom syndrome characterized by “urinary urgency, usually accompanied by frequency and nocturia, with or without urgency urinary incontinence, in the absence of urinary tract infection or other obvious pathology” (Abrams et al, 2002). The prevalence of OAB increases with advancing age and is greatly varied across studies. A population-based survey included over 19,000 participants and demonstrated an overall prevalence of OAB to be 11.8% (10.8% in men and 12.8% in women). As OAB is a separate syndrome, its symptoms could be found in numerous diseases of other non-urogenital systems, such as diabetes, cardiovascular diseases, and sleep disorders. Given the basis of the condition relying on a subjective symptom of urgency, available animal models with indirect or surrogate markers of urgency have been applied for basic science research into OAB.

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