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Do functional changes occur in the bladder due to bladder outlet obstruction? - ICI-RS 2018
Ruud Bosch1, Paul Abrams2, Marcio Augusto Averbeck3
1Department of Urology, University Medical Centre Utrecht, Utrecht, The Netherlands.
Neurourology and Urodynamics
|July 7, 2019
Summary
Bladder outlet obstruction causes bladder remodeling in three stages: hypertrophy, compensation, and decompensation. Factors like age and obstruction severity influence the progression of bladder dysfunction.
Area of Science:
- Urology
- Physiology
Background:
- Bladder dysfunction (BD) and functional-urodynamic changes are significant clinical concerns.
- Bladder outlet obstruction (BOO) is a common cause of secondary bladder dysfunction.
Purpose of the Study:
- To summarize existing evidence on BOO-induced bladder remodeling.
- To propose a three-stage model for BOO-induced bladder changes.
Main Methods:
- Review of available human studies on bladder dysfunction due to BOO.
- Hypothesizing a three-stage model based on limited evidence.
Main Results:
- A three-stage model of BOO-induced bladder remodeling is proposed: hypertrophy, compensation, and decompensation (detrusor underactivity).
- The progression from compensation to decompensation is influenced by obstruction characteristics and patient factors.
- Clinical factors like vascular and metabolic issues can mitigate BOO progression.
Conclusions:
- Understanding the factors influencing BOO progression can aid in personalized patient management.
- This model provides a framework for predicting timelines and probabilities of decompensation in obstructed patients.
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