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Afferents and lower urinary tract symptoms: Pathophysiology and future afferent therapy

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Abstract

Agents that block the efferent function of micturition reflex, such as antimuscarinics, are currently first-line therapy for overactive bladder (OAB) and neurogenic detrusor overactivity. Many urologists believe that the actual “efferent” pharmacologic management of OAB is not completely satisfactory. Consequently, research is trying to address issues of efficacy, tolerability, and convenience of new therapeutic strategies targeting the “afferent” function. This article discusses the rationale underlying the development of new drugs and the use of electrical modulation to manage lower urinary tract dysfunctions. It also offers insight into the mechanism of action, efficacy, side effects, and market status of several drugs that target the afferent branch of micturition reflex (vanilloids, botulinum toxin, tachykinin, nociceptin/orphanin FQ) and sacral neuromodulation.

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Authors and Affiliations

  1. Department of Urology, Santa Chiara Hospital, Piazza Indipendenza, 11, 50129, Florence, Italy

    Massimo Lazzeri

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  1. Massimo Lazzeri
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  2. Michele Spinelli
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Correspondence to Massimo Lazzeri.

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Lazzeri, M., Spinelli, M. Afferents and lower urinary tract symptoms: Pathophysiology and future afferent therapy. Curr Bladder Dysfunct Rep 3, 217–223 (2008). https://doi.org/10.1007/s11884-008-0032-5

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  • DOI: https://doi.org/10.1007/s11884-008-0032-5

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