What is the mechanism of action of anticholinergics in the bladder – is it neurogenic or non-neurogenic?

Abstract

The human urinary bladder is a highly – compliant storage device and nerve supply to the bladder is relatively complex. Dysfunction of the nervous system could affect the urinary bladder negatively, a condition called ‘neurogenic bladder’. Among neurogenic bladder complications, urinary incontinence is the most significant factor in determining quality of life. Urinary incontinence in neurogenic bladder is explained by detrusor overactivity on urodynamic assessment. Oral anticholinergic medications are largely accepted as the cornerstone in the management of neurogenic detrusor overactivity. In this review article, we closely analyse the mechanism by which anticholinergic treatment help increasing bladder compliance and bladder capacity and reducec involuntary detrusor contraction in neurogenic bladder cases

Keywords

• anticholinergic treatment,detrusor overactivity,neurogenic bladder

Antikolinerjik ilaçların mesane üzerinde ki etki mekanizması nedir – nörojenik mi yoksa non-nörojenik mi?

Abstract

İnsan mesanesi, kompliansı yüksek, sinirsel desteği ise oldukça kompleks yapıda bir depolama organıdır. Bu bölgeyi innerve eden sinir sisteminin disfonksiyonu nörojen mesane olarak adlandırılmakta ve mesane fonksiyonlarını değişen derecelerde etkileyebilmektedir. Nörojen mesaneye bağlı oluşan semptomlar içerisinde yaşam kalitesini en çok etkileyeni idrar inkontinansı olarak bildirilmektedir. Nörojen mesanede idrar inkontinansı oluşumunun en önemli mekanizmlarından birisi ürodinamik çalışmada detrüsör aşırı aktivitesi ile izah edilmektedir. Oral antikolinerjik ilaçlar nörojen detrüsör aşırı aktivitesinin tedavisinde dönüm noktası olarak kabul edilirler. Bu derlemede nörojen mesane olgularında mesane kompliansını ve kapasitesini arttırmak ve istemsiz detrüsör kontraksiyonlarını azaltmak için kullanılan antikolinerjik tedavinin etki mekanizmasını analiz ettik

Keywords

• antikolinerjik tedavi,detrüsör aşırı aktivitesi,nörojenik mesane

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