[Terminology and Pathophysiology of Overactive Bladder (OAB)]

Area of Science:

• Urology
• Nephrology
• Physiology

Background:

• Overactive bladder (OAB) is defined as a symptom syndrome including urgency, with or without urge incontinence, frequency, and nocturia.
• Exclusion of urinary tract infections and other pathologies is necessary for OAB diagnosis.
• The detailed pathophysiology of OAB remains unclear and is an active area of research.

Purpose of the Study:

• To explore the current hypotheses regarding the pathophysiology of overactive bladder (OAB).
• To summarize the proposed mechanisms underlying OAB symptoms.

Main Methods:

• Review and synthesis of existing scientific literature and hypotheses on OAB pathophysiology.
• Analysis of urothelium-based, myogenic, and central nervous system-based theories.

Main Results:

• The urothelium-based hypothesis points to altered urothelial receptors and suburothelial myofibroblast function, increasing afferent signals.
• The myogenic hypothesis suggests detrusor instability due to changes in myocyte excitability and coupling.
• The abnormal processing of afferent signals hypothesis involves impaired central inhibitory pathways or sensitized afferent nerves.

Conclusions:

• Multiple overlapping hypotheses, including urothelial, myogenic, and neural factors, contribute to the complex pathophysiology of OAB.
• Further research is needed to fully elucidate the mechanisms driving OAB symptoms.
• Hormonal and psychological influences are also considered potential contributing factors to OAB.