title: [Noxious stimuli and neurogenic overactive bladder].
abstract: OBJECTIVE
  Describe the relationships between neurogenic overactive bladder and noxious stimuli.
  
  
  METHODS
  Relevant data from the literature were identified primarily through a Medline search of articles published through July 2014. The search terms included overactive bladder, central nervous system, noxious visceral and cutaneous stimuli.
  
  
  RESULTS
  Overactive bladder often due to overactive detrusor is the most common symptom observed in central neurogenic bladder (70 to 80% in case of spinal cord injury). Pathophysiological mechanisms are various and numerous. Noxious cutaneous stimuli may determine, or maintain, these symptoms by increased afferent inputs in segmental levels, particularly S2S3 levels, determining exaggerated visceral, muscle and bladder responses depending on this considered medullary level. These modifications are only observed in case of central neurogenic lesions secondary to spinal cord involvement. Animal researches have precised the role of lack of the supra-segmental inhibition.
  
  
  CONCLUSIONS
  In presence of neurogenic overactive bladder, it is always necessary to track down noxious stimuli particularly in case of modifications of clinical or urodynamic status or when the usual treatments, generally anticholinergic drugs, have a reduced efficacy. Treatment is first focused on the suppression of these noxious cutaneous stimuli.
authors.affiliation: Centre Bouffard-Vercelli-Cap Peyrefitte, 66290 Cerbère, France; UPMC, GRC 01, GREEN, group of clinical research in neuro-urology, Sorbonne universités, université Paris 06, 75005 Paris, France. Electronic address: jmsoler66@aol.com.
authors.forename: J-M
authors.initials: JM
authors.lastname: Soler
authors.affiliation: UPMC, GRC 01, GREEN, group of clinical research in neuro-urology, Sorbonne universités, université Paris 06, 75005 Paris, France; Service de neuro-urologie, hôpital Tenon, AP-HP, 75020 Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Amarenco
mesh_terms: D006801:Humans; D059225:Nociception; D001750:Urinary Bladder, Neurogenic / Q000209:etiology / Q000503:physiopathology*; D053201:Urinary Bladder, Overactive / Q000209:etiology / Q000503:physiopathology*
keywords: Hyperactivité du detrusor; Hyperactivité vésicale; Inhibition; Neuro-modulation; Neurogenic overactive bladder; Overactive detrusor; Reflex; Réflexe