title: Advanced therapeutic directions to treat the underactive bladder.
abstract: Muscarinic agonists are the most commonly used agents for treating the underactive bladder (UAB). However, because of the absence of pharmacologic specificity for bladder-only effects and possibly as a result of degenerative and other post-synaptic changes involving detrusor smooth muscle cells, they are simply not effective and side effects are common. If safe and effective therapy for UAB is made available, then most experts agree that the potential market would exceed industry expectations, just as antimuscarinic agents for overactive bladder did in the late 1990 s. The pharmaceutical and biotechnology industries that have a pipeline to urology and women's health should consider UAB as a potential target condition. A rational approach to treating the pathology of UAB is presented with a discussion of potential targets that may allow the development of safe and effective agents for the treatment of UAB.
authors.affiliation: Department of Surgery, University of Connecticut Health Center, Farmington, CT, USA.
authors.forename: Phillip P
authors.initials: PP
authors.lastname: Smith
authors.forename: Pradeep
authors.initials: P
authors.lastname: Tyagi
authors.forename: George A
authors.initials: GA
authors.lastname: Kuchel
authors.forename: Subrata
authors.initials: S
authors.lastname: Pore
authors.forename: Christopher
authors.initials: C
authors.lastname: Chermansky
authors.forename: Michael
authors.initials: M
authors.lastname: Chancellor
authors.forename: Naoki
authors.initials: N
authors.lastname: Yoshimura
authors.forename: Peter
authors.initials: P
authors.lastname: Levanovich
mesh_terms: D000818:Animals; D002800:Cholinesterase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D015232:Dinoprostone / Q000627:therapeutic use; D004599:Electric Stimulation Therapy; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000209:etiology; D018721:Muscarinic Agonists / Q000009:adverse effects / Q000627:therapeutic use*; D009119:Muscle Contraction; D009130:Muscle, Smooth / Q000503:physiopathology*; D001743:Urinary Bladder / Q000503:physiopathology*; D001745:Urinary Bladder Diseases / Q000150:complications / Q000188:drug therapy* / Q000628:therapy*
chemical_list: D002800:Cholinesterase Inhibitors; D018721:Muscarinic Agonists; D015232:Dinoprostone