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The afferent system and its role in lower urinary tract dysfunction.
Curr Opin Urol. 2011 Jul; 21(4):268-74.CO

Abstract

PURPOSE OF REVIEW

Lower urinary tract disorders such as overactive bladder syndrome (OABS) and interstitial cystitis/painful bladder syndrome (IC/PBS) are debilitating conditions with serious adverse effects on quality of life. Common to both OABS and IC/PBS are the sensory symptoms of urgency and frequency, implicating the afferent system in the aetiology of these disorders. Thus, understanding the role that afferent pathways play in the function of the lower urinary tract is the focus of much current research. This review aims to provide an insight into the recent advances in this field.

RECENT FINDINGS

Sensory transduction in the bladder is not only mediated by direct activation of the afferents via a host of receptors and ion channels located on the afferent terminal but also may be attributed to the interplay between the urothelium and the release of urothelially derived mediators. Recent studies provide compelling evidence to support this concept and highlight the complex nature of the bladder afferent system.

SUMMARY

Recent studies provide further evidence that afferent control of the bladder may be dependent on integration of excitatory and inhibitory mediators from the urothelium such as ATP and nitric oxide. A number of studies have examined the role cholinergic and adrenergic mechanisms play in bladder afferent function, and several new potential mechanisms involving the cannabinoid receptors and transient receptor potential channels have emerged as areas which warrant further investigation. A better understanding of afferent mechanisms in the bladder will hopefully lead to more effective treatments of lower urinary tract disorders.

Authors+Show Affiliations

University of Sheffield, Western Bank, and Royal Hallamshire Hospital, Glossop Road, Sheffield, UK. d.daly@sheffield.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

21537194

Citation

Daly, Donna M., et al. "The Afferent System and Its Role in Lower Urinary Tract Dysfunction." Current Opinion in Urology, vol. 21, no. 4, 2011, pp. 268-74.
Daly DM, Collins VM, Chapple CR, et al. The afferent system and its role in lower urinary tract dysfunction. Curr Opin Urol. 2011;21(4):268-74.
Daly, D. M., Collins, V. M., Chapple, C. R., & Grundy, D. (2011). The afferent system and its role in lower urinary tract dysfunction. Current Opinion in Urology, 21(4), 268-74. https://doi.org/10.1097/MOU.0b013e3283476ea2
Daly DM, et al. The Afferent System and Its Role in Lower Urinary Tract Dysfunction. Curr Opin Urol. 2011;21(4):268-74. PubMed PMID: 21537194.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The afferent system and its role in lower urinary tract dysfunction. AU - Daly,Donna M, AU - Collins,Valerie M, AU - Chapple,Christopher R, AU - Grundy,David, PY - 2011/5/4/entrez PY - 2011/5/4/pubmed PY - 2011/10/1/medline SP - 268 EP - 74 JF - Current opinion in urology JO - Curr Opin Urol VL - 21 IS - 4 N2 - PURPOSE OF REVIEW: Lower urinary tract disorders such as overactive bladder syndrome (OABS) and interstitial cystitis/painful bladder syndrome (IC/PBS) are debilitating conditions with serious adverse effects on quality of life. Common to both OABS and IC/PBS are the sensory symptoms of urgency and frequency, implicating the afferent system in the aetiology of these disorders. Thus, understanding the role that afferent pathways play in the function of the lower urinary tract is the focus of much current research. This review aims to provide an insight into the recent advances in this field. RECENT FINDINGS: Sensory transduction in the bladder is not only mediated by direct activation of the afferents via a host of receptors and ion channels located on the afferent terminal but also may be attributed to the interplay between the urothelium and the release of urothelially derived mediators. Recent studies provide compelling evidence to support this concept and highlight the complex nature of the bladder afferent system. SUMMARY: Recent studies provide further evidence that afferent control of the bladder may be dependent on integration of excitatory and inhibitory mediators from the urothelium such as ATP and nitric oxide. A number of studies have examined the role cholinergic and adrenergic mechanisms play in bladder afferent function, and several new potential mechanisms involving the cannabinoid receptors and transient receptor potential channels have emerged as areas which warrant further investigation. A better understanding of afferent mechanisms in the bladder will hopefully lead to more effective treatments of lower urinary tract disorders. SN - 1473-6586 UR - https://www.unboundmedicine.com/medline/citation/21537194/The_afferent_system_and_its_role_in_lower_urinary_tract_dysfunction_ L2 - https://doi.org/10.1097/MOU.0b013e3283476ea2 DB - PRIME DP - Unbound Medicine ER -