A Refocus on the Bladder as the Originator of Storage Lower Urinary Tract Symptoms: A Systematic Review of the Latest Literature

Alexander Roosen, Christopher R. Chapple, Roger R. Dmochowski, Clare J. Fowler, Christian Gratzke, Claus Roehrborn, Christian G. Stief, Karl Erik Andersson

Research output: Contribution to journalArticle

90 Citations (Scopus)

Abstract

Context: The focus of clinical understanding and management of male storage lower urinary tract symptoms (LUTS) has shifted from the prostate to the bladder. This is mirrored by an increasing body of experimental evidence suggesting that the bladder is the central organ in the pathogenesis of LUTS. Objective: A systematic review of the literature available on pathophysiologic aspects of storage LUTS. Evidence acquisition: Medline was searched for the period ending December 2008 for studies on human and animal tissue exploring possible functional and structural alterations underlying bladder dysfunction. Further studies were chosen on the basis of manual searches of reference lists and review papers. Evidence synthesis: Numerous recent publications on LUTS pathophysiology were identified. They were grouped into studies exploring abnormalities on urothelial/suburothelial, muscular, or central levels. Conclusions: Studies revealed both structural and functional alterations in bladders from patients with LUTS symptoms or animals with experimentally induced bladder dysfunction. In particular, the urothelium and the suburothelial space, containing afferent nerve fibres and interstitial cells, have been found to form a functional unit that is essential in the process of bladder function. Various imbalances within this suburothelial complex have been identified as significant contributors to the generation of storage LUTS, along with potential abnormalities of central function.

Original languageEnglish (US)
Pages (from-to)810-820
Number of pages11
JournalEuropean Urology
Volume56
Issue number5
DOIs
StatePublished - Nov 2009

Fingerprint

Lower Urinary Tract Symptoms
Urinary Bladder
Urothelium
Nerve Fibers
Prostate

Keywords

  • Detrusor overactivity
  • LUTS
  • Muscular alterations
  • Neurogenic alterations
  • Overactive bladder
  • Urothelial and suburothelial alterations

ASJC Scopus subject areas

  • Urology

Cite this

A Refocus on the Bladder as the Originator of Storage Lower Urinary Tract Symptoms : A Systematic Review of the Latest Literature. / Roosen, Alexander; Chapple, Christopher R.; Dmochowski, Roger R.; Fowler, Clare J.; Gratzke, Christian; Roehrborn, Claus; Stief, Christian G.; Andersson, Karl Erik.

In: European Urology, Vol. 56, No. 5, 11.2009, p. 810-820.

Research output: Contribution to journalArticle

Roosen, Alexander ; Chapple, Christopher R. ; Dmochowski, Roger R. ; Fowler, Clare J. ; Gratzke, Christian ; Roehrborn, Claus ; Stief, Christian G. ; Andersson, Karl Erik. / A Refocus on the Bladder as the Originator of Storage Lower Urinary Tract Symptoms : A Systematic Review of the Latest Literature. In: European Urology. 2009 ; Vol. 56, No. 5. pp. 810-820.
@article{32f89e7ef2a247c49870261a2039bfee,
title = "A Refocus on the Bladder as the Originator of Storage Lower Urinary Tract Symptoms: A Systematic Review of the Latest Literature",
abstract = "Context: The focus of clinical understanding and management of male storage lower urinary tract symptoms (LUTS) has shifted from the prostate to the bladder. This is mirrored by an increasing body of experimental evidence suggesting that the bladder is the central organ in the pathogenesis of LUTS. Objective: A systematic review of the literature available on pathophysiologic aspects of storage LUTS. Evidence acquisition: Medline was searched for the period ending December 2008 for studies on human and animal tissue exploring possible functional and structural alterations underlying bladder dysfunction. Further studies were chosen on the basis of manual searches of reference lists and review papers. Evidence synthesis: Numerous recent publications on LUTS pathophysiology were identified. They were grouped into studies exploring abnormalities on urothelial/suburothelial, muscular, or central levels. Conclusions: Studies revealed both structural and functional alterations in bladders from patients with LUTS symptoms or animals with experimentally induced bladder dysfunction. In particular, the urothelium and the suburothelial space, containing afferent nerve fibres and interstitial cells, have been found to form a functional unit that is essential in the process of bladder function. Various imbalances within this suburothelial complex have been identified as significant contributors to the generation of storage LUTS, along with potential abnormalities of central function.",
keywords = "Detrusor overactivity, LUTS, Muscular alterations, Neurogenic alterations, Overactive bladder, Urothelial and suburothelial alterations",
author = "Alexander Roosen and Chapple, {Christopher R.} and Dmochowski, {Roger R.} and Fowler, {Clare J.} and Christian Gratzke and Claus Roehrborn and Stief, {Christian G.} and Andersson, {Karl Erik}",
year = "2009",
month = "11",
doi = "10.1016/j.eururo.2009.07.044",
language = "English (US)",
volume = "56",
pages = "810--820",
journal = "European Urology",
issn = "0302-2838",
publisher = "Elsevier",
number = "5",

}

TY - JOUR

T1 - A Refocus on the Bladder as the Originator of Storage Lower Urinary Tract Symptoms

T2 - A Systematic Review of the Latest Literature

AU - Roosen, Alexander

AU - Chapple, Christopher R.

AU - Dmochowski, Roger R.

AU - Fowler, Clare J.

AU - Gratzke, Christian

AU - Roehrborn, Claus

AU - Stief, Christian G.

AU - Andersson, Karl Erik

PY - 2009/11

Y1 - 2009/11

N2 - Context: The focus of clinical understanding and management of male storage lower urinary tract symptoms (LUTS) has shifted from the prostate to the bladder. This is mirrored by an increasing body of experimental evidence suggesting that the bladder is the central organ in the pathogenesis of LUTS. Objective: A systematic review of the literature available on pathophysiologic aspects of storage LUTS. Evidence acquisition: Medline was searched for the period ending December 2008 for studies on human and animal tissue exploring possible functional and structural alterations underlying bladder dysfunction. Further studies were chosen on the basis of manual searches of reference lists and review papers. Evidence synthesis: Numerous recent publications on LUTS pathophysiology were identified. They were grouped into studies exploring abnormalities on urothelial/suburothelial, muscular, or central levels. Conclusions: Studies revealed both structural and functional alterations in bladders from patients with LUTS symptoms or animals with experimentally induced bladder dysfunction. In particular, the urothelium and the suburothelial space, containing afferent nerve fibres and interstitial cells, have been found to form a functional unit that is essential in the process of bladder function. Various imbalances within this suburothelial complex have been identified as significant contributors to the generation of storage LUTS, along with potential abnormalities of central function.

AB - Context: The focus of clinical understanding and management of male storage lower urinary tract symptoms (LUTS) has shifted from the prostate to the bladder. This is mirrored by an increasing body of experimental evidence suggesting that the bladder is the central organ in the pathogenesis of LUTS. Objective: A systematic review of the literature available on pathophysiologic aspects of storage LUTS. Evidence acquisition: Medline was searched for the period ending December 2008 for studies on human and animal tissue exploring possible functional and structural alterations underlying bladder dysfunction. Further studies were chosen on the basis of manual searches of reference lists and review papers. Evidence synthesis: Numerous recent publications on LUTS pathophysiology were identified. They were grouped into studies exploring abnormalities on urothelial/suburothelial, muscular, or central levels. Conclusions: Studies revealed both structural and functional alterations in bladders from patients with LUTS symptoms or animals with experimentally induced bladder dysfunction. In particular, the urothelium and the suburothelial space, containing afferent nerve fibres and interstitial cells, have been found to form a functional unit that is essential in the process of bladder function. Various imbalances within this suburothelial complex have been identified as significant contributors to the generation of storage LUTS, along with potential abnormalities of central function.

KW - Detrusor overactivity

KW - LUTS

KW - Muscular alterations

KW - Neurogenic alterations

KW - Overactive bladder

KW - Urothelial and suburothelial alterations

UR - http://www.scopus.com/inward/record.url?scp=70349269052&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=70349269052&partnerID=8YFLogxK

U2 - 10.1016/j.eururo.2009.07.044

DO - 10.1016/j.eururo.2009.07.044

M3 - Article

C2 - 19683859

AN - SCOPUS:70349269052

VL - 56

SP - 810

EP - 820

JO - European Urology

JF - European Urology

SN - 0302-2838

IS - 5

ER -