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Current Bladder Dysfunction Reports
Published in: Current Bladder Dysfunction Reports 4/2017

01-12-2017 | Reconstructed Bladder Function & Dysfunction (M Kaufman, Section Editor)

Impact of Autonomic Dysfunction on Lower Urinary Tract Symptoms

Authors: Casey G. Kowalik, Joshua A. Cohn, Melissa R. Kaufman, W. Stuart Reynolds, Roger R. Dmochowski, Douglas F. Milam

Published in: Current Bladder Dysfunction Reports | Issue 4/2017

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Abstract

Purpose of Review

Normal bladder function involves complex interactions of the autonomic nervous system. Patients with autonomic disorders may experience lower urinary tract dysfunction due to disruption of the micturition pathways. In this article, we review relevant anatomy involved in the neural control of micturition and examine the impact of functional and structural autonomic disorders on the lower urinary tract.

Recent Findings

Depending on the etiology and localization of the autonomic disorder, patients with dysautonomias can experience a variety of urinary symptoms, including urinary hesitancy, urgency, and incontinence. Studies suggest a clinical association between diabetes and bladder dysfunction as a result of autonomic neuropathy. The majority of patients with lower urinary tract symptoms and multiple system atrophy or Parkinson’s disease has detrusor overactivity on urodynamic evaluation, reflecting that the voiding reflex is not inhibited by supraspinal control centers. Recent data also shows that alterations in the autonomic system may be involved in the pathogenesis of bladder pain syndrome and interstitial cystitis.

Summary

LUT dysfunction in patients with autonomic disorders can significantly affect quality of life and be difficult to treat, highlighting a need for continued research efforts in this area.
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Metadata
Title
Impact of Autonomic Dysfunction on Lower Urinary Tract Symptoms
Authors
Casey G. Kowalik
Joshua A. Cohn
Melissa R. Kaufman
W. Stuart Reynolds
Roger R. Dmochowski
Douglas F. Milam
Publication date
01-12-2017
Publisher
Springer US
Published in
Current Bladder Dysfunction Reports / Issue 4/2017
Print ISSN: 1931-7212
Electronic ISSN: 1931-7220
DOI
https://doi.org/10.1007/s11884-017-0426-3

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