title: Urethral Sensations are Related to the Development of Detrusor Overactivity.
abstract: Urgency is the core symptom of the overactive bladder symptom complex, but the underlying mechanisms are not fully understood. Clinical findings have led to the assumption that bladder outlet obstruction (BOO) caused by benign prostatic enlargement (BPE) induces storage symptoms and detrusor overactivity. Presumably, BOO by BPE accounts for urgency; however, urgency is not always caused by BOO. Sensory nerves in the wall of the urethra fire in response to urethral fluid flow, and this activity initiates bladder contractions in the quiescent bladder and augments ongoing contractions in the active bladder. In humans, prostatic urethral anesthesia results in significant increases in bladder capacity among BPH patients without neurological diseases, therefore sensory stimuli from an anatomically altered prostatic urethra has the possibility to induce urgency and detrusor overactivity. Studies in animals demonstrate the basis for an excitatory urethra to bladder reflex. Urethral stimulation by prostaglandin E2 induces an excitatory effect on micturition reflex by activation of C-fiber afferent nerves. α1A -adrenoceptor blocker has an inhibitory effect on the micturition reflex, suggesting excitatory urethra to bladder reflex is mediated by α1A -adrenoceptor. Even if there is no obstruction, increase in urethral sensory due to BPE may induce the development of the detrusor overactivity.
authors.affiliation: Faculty of Medical Science, Department of Urology, University of Fukui, Fukui, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Yokoyama
authors.affiliation: Faculty of Medical Science, Department of Urology, University of Fukui, Fukui, Japan.
authors.forename: Yoshiji
authors.initials: Y
authors.lastname: Miwa
authors.affiliation: Faculty of Medical Science, Department of Urology, University of Fukui, Fukui, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Oyama
authors.affiliation: Faculty of Medical Science, Department of Urology, University of Fukui, Fukui, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Aoki
authors.affiliation: Faculty of Medical Science, Department of Urology, University of Fukui, Fukui, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Ito
authors.affiliation: Faculty of Medical Science, Department of Urology, University of Fukui, Fukui, Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Tanase
authors.affiliation: Faculty of Medical Science, Department of Urology, University of Fukui, Fukui, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Ishida
authors.affiliation: Faculty of Medical Science, Department of Urology, University of Fukui, Fukui, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Matsuta
authors.affiliation: Faculty of Medical Science, Department of Urology, University of Fukui, Fukui, Japan.
authors.forename: Naoya
authors.initials: N
authors.lastname: Kusukawa
authors.affiliation: Faculty of Medical Science, Department of Urology, University of Fukui, Fukui, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yamauchi
authors.affiliation: Faculty of Medical Science, Department of Urology, University of Fukui, Fukui, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Takahara
authors.affiliation: Faculty of Medical Science, Department of Urology, University of Fukui, Fukui, Japan.
authors.forename: Nozomu
authors.initials: N
authors.lastname: Watanabe
authors.affiliation: Faculty of Medical Science, Department of Urology, University of Fukui, Fukui, Japan.
authors.forename: Katsuki
authors.initials: K
authors.lastname: Tsuchiyama
authors.affiliation: Faculty of Medical Science, Department of Urology, University of Fukui, Fukui, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yokoi
authors.affiliation: Faculty of Medical Science, Department of Urology, University of Fukui, Fukui, Japan.
authors.forename: Hironobu
authors.initials: H
authors.lastname: Akino
keywords: detrusor overactivity; prostatic hyperplasia; sensory; urethra; urinary bladder