Age‐related changes in urinary bladder intramural neurons

Clinics in Geriatric Medicine

Andersson

2015

Synopsis This article describes a number of changes in lower urinary tract (LUT) function that occurs in the aging population as well as in animal models. Age-related LUT dysfunctions result from complex processes controlled by multiple genetic, epigenetic and environmental factors and accounts for high costs of healthcare. While the underlying factors that contribute to patient symptoms are not known, this article will discuss a number of risk factors that may play a role in age- related LUT dysfunction. In addition, while limited data is available using animal models of aging, there is evidence that many of the structural and functional changes observed in these studies appear to be similar to those observed in humans. A better understanding of factors and mechanisms underlying LUTS in the older population may lead to therapeutic interventions which may be used to reduce these dysfunctions.

Section: Animal Models Of Aging-related Bladder Dysfunctionsupporting

confidence: 81%

Translational Research and Functional Changes in Voiding Function in Older Adults

Kullmann

Clinics in Geriatric Medicine

Andersson

2015

“…These could be the results of oxidative stress and altered mitochondrial function. In support, increased reactive oxygen species (ROS) in cultured urothelial cells, associated with upregulation of transient receptor potential cation channel subfamily M member 8 (TRPM8) [28] , decreased total antioxidant capacity and significantly increased levels of lipid peroxides, malondialdehyde (MDA) and inducible nitric oxide synthase (iNOS) (markers of oxidative stress) as well as ultrastructural alterations in mitochondria with accumulation of lipofuscin [29] have been reported. Changes in the urothelium can affect afferent neuronal input.…”

Section: In Vitro Evaluation Of Age Related Changes In Mictumentioning

confidence: 97%

The aging bladder insights from animal models

Asian Journal of Urology

Kullmann

Chapple

2018

Alterations in bladder function with aging are very common and are very likely to represent an increasing healthcare problem in the years to come with the general aging of the population. In this review the authors describe the prevalence of lower urinary tract symptoms (LUTS) and comment upon potential mechanisms which may be responsible for the increasing prevalence of lower LUTS with increasing age, based on laboratory studies. It is clear that there is a complex interplay between the various components of the neural innervation structure of the bladder in leading to changes with age, which are likely to underpin the LUTS which are seen in the aging bladder.

“…In contrast, the neurogenic hypothesis holds that myocyte and detrusor contractile abilities are intact, and that insufficiencies in expulsive pressure creation are the result of inadequate stimulation once the pontine voiding mechanism is triggered. This could be as a result of insufficient postganglionic efferent nerve stimulation e.g., poor central motor drive, such as in some brain injury (ischemia, trauma) patients, or due to neuropathic changes within the detrusor such as has been reported with aging and chronic outlet obstruction . While voiding detrusor contraction in humans is classically regarded as cholinergically mediated, other signalling pathways, primarily purinergic, may assume importance in disease and aging .…”

Section: Etiologic Considerationsmentioning

confidence: 99%

Detrusor underactivity and the underactive bladder: Symptoms, function, cause-what do we mean? ICI-RS think tank 2014

Smith

Abrams

et al. 2016

Neurourol. Urodynam.

Impaired bladder emptying is a well-recognized cause of lower urinary tract symptoms. However, the symptoms produced do not always relate to voiding, and may include frequency, urgency and incontinence. Conversely, the etiology of symptoms of disturbed voiding is not necessarily dependent upon objectively impaired voiding. Terms including underactive bladder, detrusor underactivity, and impaired contractility describe aspects of these problems, and have been used somewhat interchangeably. It is possible that the present lack of effective therapy in many cases relates to both etiologic and diagnostic uncertainty stemming from terminologic imprecision. Detrusor underactivity has a standardized definition, unlike underactive bladder and impaired contractility. The relationships of symptoms, function, and cause were the focus of a 2014 ICI-RS Think Tank entitled Does Detrusor Underactivity Exist, and if so it is neurogenic, myogenic, or both? This review presents a summary of the problem and the Think Tank conclusions. A terminologic hierarchy and specific research goals are presented.