title: [Neurology and the bladder: how to assess and manage neurogenic bladder dysfunction, with particular references to the neural control of micturition].
abstract: 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.
authors.affiliation: Neurology, Internal Medicine, Sakura Medical Center, Toho University.
authors.forename: Ryuji
authors.initials: R
authors.lastname: Sakakibara
authors.forename: Fuyuki
authors.initials: F
authors.lastname: Tateno
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kishi
authors.forename: Yohei
authors.initials: Y
authors.lastname: Tsuyusaki
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Uchiyama
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Yamamoto
mesh_terms: D000109:Acetylcholine / Q000378:metabolism; D000818:Animals; D018680:Cholinergic Antagonists / Q000627:therapeutic use*; D006801:Humans; D009435:Synaptic Transmission; D001750:Urinary Bladder, Neurogenic / Q000188:drug therapy* / Q000503:physiopathology; D053201:Urinary Bladder, Overactive / Q000188:drug therapy* / Q000503:physiopathology; D014555:Urination Disorders / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D018680:Cholinergic Antagonists; D000109:Acetylcholine