[Clinical and urodynamic rationale of the overactive bladder neurophysiological model]

The analysis of 58 cases of overactive bladder has shown that detrusor activity is not linked with clinical symptoms but is caused by supra segmentary lesion of the nervous system. The clinical picture of overactive bladder fits the proposed neurophysiological model where ischemic damage of the association neuron located in the lumbar spinal marrow triggers miction disorders leading to preganglionary detrusor denervation. Combined therapy with alpha1-adrenoblocker and M-cholinolytic is pathogenetically sound. Trospium chloride (spasmex) was used for long-term treatment of the patients as it produces minimal number of side effects and enables dose and schedule variation.