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Urinary Bladder Distention Evoked Visceromotor Responses as a Model for Bladder Pain in Mice
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Current concepts of the acontractile bladder.

Marc Colaco1, Nadir I Osman2, Ahmet Karakeçi3

  • 1Wake Forest School of Medicine, Winston-Salem, NC, USA.

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|April 11, 2018
PubMed
Summary

Acontractile bladder (AcB) is a distinct urodynamic diagnosis. Current treatments focus on symptom management and renal preservation, with limited restorative options available.

Keywords:
acontractile bladderacontractile detrusordetrusor areflexiaunderactive bladderurodynamic evaluation

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Area of Science:

  • Urology
  • Nephrology
  • Physiology

Background:

  • Acontractile bladder (AcB) is a urodynamic diagnosis characterized by the inability to demonstrate bladder contraction during a pressure flow study.
  • Often misclassified with underactive bladder, AcB is a unique condition requiring independent investigation.

Purpose of the Study:

  • To review the existing literature on acontractile bladder (AcB).
  • To examine the pathology, diagnostic methods, current management strategies, and future therapeutic developments for AcB.

Main Methods:

  • A comprehensive review of the PubMed database was conducted.
  • Studies published over a 67-year period were identified and classified based on evidence for AcB pathology, diagnosis, and treatment.

Main Results:

  • Forty-two studies met the inclusion criteria, though the overall quality was largely poor, consisting mainly of retrospective reviews and animal models.
  • The underlying pathology of AcB is heterogeneous, encompassing both neurological and myogenic causes.
  • Current management primarily focuses on renal preservation and infection reduction, with treatments mainly involving bladder drainage.

Conclusions:

  • Acontractile bladder (AcB) is an understudied condition with variable pathology.
  • Existing treatments are primarily symptomatic, emphasizing bladder drainage and renal protection.
  • Future research into neuro-urological pathophysiology is crucial for developing more effective, potentially restorative, treatments like cellular therapy and neuromodulation.