Autonomic nervous system and overactive bladder: A systematic review.

Area of Science:

• Urology
• Autonomic Neuroscience
• Systems Biology

Background:

• Lower urinary tract symptoms (LUTS), encompassing overactive bladder (OAB) and LUTS associated with benign prostatic hyperplasia (LUTS-BPH), are prevalent conditions impacting quality of life.
• The role of autonomic nervous system (ANS) dysregulation in the pathophysiology of these conditions remains incompletely understood.
• Evaluating the ANS's involvement is crucial for developing targeted and effective therapeutic strategies.

Approach:

• A systematic literature review was conducted following PRISMA guidelines, searching PubMed, Scopus, and Embase.
• Studies investigating non-neurogenic OAB and LUTS-BPH with assessments of ANS dysfunction (e.g., heart rate variability, skin sympathetic response) were included.
• Data on ANS dysfunction and the impact of interventions on ANS function were extracted and analyzed.

Key Points:

• Thirteen studies on OAB indicated inconsistent patterns of sympathetic and parasympathetic imbalance, with heart rate variability being the most common assessment method.
• Four studies on LUTS-BPH suggested a potential association between ANS dysfunction and symptom severity.
• Fourteen studies examined various treatments (behavioral, pharmacological, neuromodulation), reporting variable effects on ANS function.

Conclusions:

• Autonomic nervous system (ANS) dysfunction is associated with OAB and LUTS-BPH, although the evidence presents heterogeneity.
• Current therapeutic interventions demonstrate varied impacts on ANS function.
• Future research should aim to identify specific ANS response patterns for improved patient stratification and personalized treatment approaches.