The Forefront for Novel Therapeutic Agents Based on the Pathophysiology of Lower Urinary Tract Dysfunction: Pathophysiology of Voiding Dysfunction and Pharmacological Therapy

• Takeda Masayuki

  Department of Urology, University of Yamanashi, Interdisciplinary Graduate School of Medicine & Engineering, Japan

• Araki Isao

  Department of Urology, University of Yamanashi, Interdisciplinary Graduate School of Medicine & Engineering, Japan

• Mochizuki Tsutomu

  Department of Urology, University of Yamanashi, Interdisciplinary Graduate School of Medicine & Engineering, Japan

• Nakagomi Hiroshi

  Department of Urology, University of Yamanashi, Interdisciplinary Graduate School of Medicine & Engineering, Japan

• Kobayashi Hideki

  Department of Urology, University of Yamanashi, Interdisciplinary Graduate School of Medicine & Engineering, Japan

• Sawada Norifumi

  Department of Urology, University of Yamanashi, Interdisciplinary Graduate School of Medicine & Engineering, Japan

• Zakohji Hidenori

  Department of Urology, University of Yamanashi, Interdisciplinary Graduate School of Medicine & Engineering, Japan

Bibliographic Information

Other Title

• Pathophysiology of voiding dysfunction and pharmacological therapy

Abstract

Normal lower urinary tract function consists of voiding and storage. During voiding, the pontine micturition reflex center orders the sacral parasympathetic nucleus to increase parasympathetic activity, resulting in urinary bladder detrusor contraction via activation of post-synaptic muscarinic receptors (M2/3) and in the relaxation of both urethral and prostatic smooth muscle by nitric oxide (NO). In addition, the rhabdosphincter relaxes by inhibition of the pudendal nucleus at the sacral portion. During the storage phase, increase in sympathetic activity relaxes the urinary bladder via activation of post-synaptic β₃-receptors and in the contraction of both urethral and prostatic smooth muscles via α₁-adrenoceptor. Many factors influence voiding function, including lower urinary tract disorders (benign prostatic hyperplasia in males, urethral stricture) and neurological disorders (central and peripheral). Theories of pharmacotherapy for voiding dysfunction are 1) increase detrusor contractility and 2) decrease urethral resistance. The former includes agonists for muscarinic receptors and cholinesterase inhibitor; and the latter includes α₁-adrenoceptor antagonists, NO donors, benzodiazepines, baclofen, dantrolene, and boturinum toxin.

Journal

• Journal of Pharmacological Sciences

  Journal of Pharmacological Sciences 112 (2), 121-127, 2010

  The Japanese Pharmacological Society

Keywords

• lower urinary tract symptoms (LUTS)
• voiding dysfunction
• pharmacotherapy

Details

• CRID: 1390001205179537408
• NII Article ID: 10029888469
• NII Book ID: AA11806667
• DOI: 10.1254/jphs.09r17fm
• ISSN: 13478648
• ISSN: 13478613
• NDL BIB ID: 10575277
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I10575277
• Web Site: https://search.jamas.or.jp/link/ui/2010238120
• Text Lang: en
• Data Source:
  • JaLC
  • NDL
  • Crossref
  • CiNii Articles
  • KAKEN
• Abstract License Flag: Disallowed