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An update on the pharmacotherapy for lower urinary tract dysfunction.
Expert Opin Pharmacother. 2015 Jan; 16(1):79-93.EO

Abstract

INTRODUCTION

The lower urinary tract (LUT) stores and evacuates urine. It is controlled by autonomic, somatic and sensory innervation. Pharmacotherapy has been developed to optimize neural control of the LUT in pathologic states.

AREAS COVERED

The bladder can be overactive or underactive. For overactive bladder, medications targeting various receptors include i) antimuscarinics, ii) mixed-action drugs, iii) β-adrenergic receptor agonists and iv) other medications. There is no effective pharmacotherapy for underactive bladder, although medications have been used with limited success, including i) muscarinic receptor agonists, ii) anticholinesterase inhibitors and iii) α-adrenergic receptor antagonists. At the level of the outlet, there can be decreased resistance resulting in stress urinary incontinence (SUI) or increased resistance resulting in bladder outflow obstruction (BOO). The classes of medications for SUI include i) α-adrenergic receptor agonists, ii) β-adrenergic receptor agonists and iii) antidepressants. Medications used to treat BOO include i) α-adrenergic receptor antagonists, ii) 5-α reductase inhibitors, iii) benzodiazepines, iv) baclofen and v) PDE inhibitors.

EXPERT OPINION

Pharmacotherapy for the LUT must be individualized based on degree of bother, medication side-effect profile, concomitant comorbidities, current medication regimen, and insurance coverage. This review describes current medical therapies for the LUT.

Authors+Show Affiliations

Montefiore Medical Center, Department of Urology , Bronx, NY USA.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

25351368

Citation

Abraham, Nitya, and Howard B. Goldman. "An Update On the Pharmacotherapy for Lower Urinary Tract Dysfunction." Expert Opinion On Pharmacotherapy, vol. 16, no. 1, 2015, pp. 79-93.
Abraham N, Goldman HB. An update on the pharmacotherapy for lower urinary tract dysfunction. Expert Opin Pharmacother. 2015;16(1):79-93.
Abraham, N., & Goldman, H. B. (2015). An update on the pharmacotherapy for lower urinary tract dysfunction. Expert Opinion On Pharmacotherapy, 16(1), 79-93. https://doi.org/10.1517/14656566.2015.977253
Abraham N, Goldman HB. An Update On the Pharmacotherapy for Lower Urinary Tract Dysfunction. Expert Opin Pharmacother. 2015;16(1):79-93. PubMed PMID: 25351368.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - An update on the pharmacotherapy for lower urinary tract dysfunction. AU - Abraham,Nitya, AU - Goldman,Howard B, Y1 - 2014/10/29/ PY - 2014/10/30/entrez PY - 2014/10/30/pubmed PY - 2015/5/8/medline KW - bladder outflow obstruction KW - iatrogenic obstruction KW - overactive bladder KW - pharmacotherapy KW - stress urinary incontinence KW - underactive bladder KW - urgency incontinence SP - 79 EP - 93 JF - Expert opinion on pharmacotherapy JO - Expert Opin Pharmacother VL - 16 IS - 1 N2 - INTRODUCTION: The lower urinary tract (LUT) stores and evacuates urine. It is controlled by autonomic, somatic and sensory innervation. Pharmacotherapy has been developed to optimize neural control of the LUT in pathologic states. AREAS COVERED: The bladder can be overactive or underactive. For overactive bladder, medications targeting various receptors include i) antimuscarinics, ii) mixed-action drugs, iii) β-adrenergic receptor agonists and iv) other medications. There is no effective pharmacotherapy for underactive bladder, although medications have been used with limited success, including i) muscarinic receptor agonists, ii) anticholinesterase inhibitors and iii) α-adrenergic receptor antagonists. At the level of the outlet, there can be decreased resistance resulting in stress urinary incontinence (SUI) or increased resistance resulting in bladder outflow obstruction (BOO). The classes of medications for SUI include i) α-adrenergic receptor agonists, ii) β-adrenergic receptor agonists and iii) antidepressants. Medications used to treat BOO include i) α-adrenergic receptor antagonists, ii) 5-α reductase inhibitors, iii) benzodiazepines, iv) baclofen and v) PDE inhibitors. EXPERT OPINION: Pharmacotherapy for the LUT must be individualized based on degree of bother, medication side-effect profile, concomitant comorbidities, current medication regimen, and insurance coverage. This review describes current medical therapies for the LUT. SN - 1744-7666 UR - https://www.unboundmedicine.com/medline/citation/25351368/An_update_on_the_pharmacotherapy_for_lower_urinary_tract_dysfunction_ L2 - https://www.tandfonline.com/doi/full/10.1517/14656566.2015.977253 DB - PRIME DP - Unbound Medicine ER -