Overactive bladder, inflammation and urinary tract infection: pathogenetic parallels

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Abstract

The review is devoted to modern ideas about the role of inflammation and urinary tract infection in the pathogenesis of overactive bladder. The molecular mechanisms of the mechanosensory function of the urothelium and the influence of bacterial colonization of the urothelium on it are described in detail. It has been shown that infectious inflammation, even in the absence of clinical symptoms, enhances the urothelial response to stretching and increases the excitability of afferent nerves. Bladder hypersensitivity and increased detrusor activity are pathogenetic basis for the development of overactive bladder. Data on the relationship between urinary infection and refractory overactive bladder are presented. The feasibility of conducting extended microbiological studies in patients with overactive bladder , especially when standard therapy is ineffective, has been demonstrated. A pathogenetic rationale for prescribing anti-inflammatory and immunoactive drugs to patients with overactive bladder is presented.

About the authors

Igor V. Kuzmin

Academician I.P. Pavlov First St. Petersburg State Medical University

Author for correspondence.
Email: kuzminigor@mail.ru
ORCID iD: 0000-0002-7724-7832
SPIN-code: 2684-4070
Scopus Author ID: 56878681300
https://www.1spbgmu.ru/ru/obrazovanie/kafedry/106-glavnaya/3828-igor-valentinovich-kuzmin

MD, Dr. Sci. (Medicine), Professor

Russian Federation, 6–8 Lva Tolstogo st., Saint Petersburg, 197022

Margarita N. Slesarevskaya

Academician I.P. Pavlov First St. Petersburg State Medical University

Email: mns-1971@yandex.ru
ORCID iD: 0000-0002-4911-6018
SPIN-code: 9602-7775
Scopus Author ID: 57196117211

MD, Cand. Sci. (Medicine)

Russian Federation, 6–8 Lva Tolstogo st., Saint Petersburg, 197022

Viktoria V. Romikh

N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology — Branch of the National Medical Research Centre of Radiology

Email: vromikh@yandex.ru
ORCID iD: 0000-0003-3342-7281
Scopus Author ID: 7761-0372

Head of the Urodynamics and Neurourology Department

Russian Federation, Moscow

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2. Fig. 1. Sensory innervation of the bladder. GAG-layer — glycosaminoglycan layer

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3. Fig. 2. Mechanosensory function of the urothelium

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4. Fig. 3. The role of urinary infection in the pathogenesis of overactive bladder

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