과민성 방광의 최신지견

• 영문명: Update of overactive bladder
• 발행기관: 대한임상노인의학회
• 저자명: 이유식(Yoo-Sik, Lee)
• 간행물 정보: 『대한임상노인의학회지』대한임상노인의학회지 제3권 제3호, 17~27쪽, 전체 10쪽
• 주제분류: 의약학 > 기타의약학
• 파일형태: PDF
• 발행일자: 2002.11.30

영문 초록

The overactive bladder is defined by the international Continence Society as a disorder of filling/storage in which involuntary bladder contraction are demonstrated while the patient is attempting to inhibit. If the involuntary bladder contraction are secondary to a known neurologic disease, the condition is known as detrusor hyperreflexia, If the involuntary bladder contraction are not due to a known neurologic disease, then the condition is known as detrusor instability. The symptom of the overactive bladder consist of urgency and/or frequency and/or nocturia and/or urge incontinence. These may exit singly or combination with one another. The overactive bladder can be manifested by any one or a combination or these symptoms. Treatment modalities of overactive blader will involve intervention along the whole route of the micturition reflex, and different modalities will be combined. Although it is well known that estrogen and progesterone receptors are present in the vagina, lower urinary tract and pelvic floor, and that symptomatic, cytologic, and urodynamic changes in the lower urinary tract had been demonstrated during the menstrual cycle, and following menopause, there have been few controlled studied of estrogen therapy on the overactive bladder. Peripheral targets for the drug treatment of the overactive bladder may be in the bladder, urethra, prostate or peripheral nerve. Antomuscarinic drugs are still the most widely used agents for the treatment of the bladder overactivity. Currently used drug, however, lack of sensitivity for the bladder, and this limits their usefulness. Currently, the muscarinic receptors remain a main target for drug used to treat the overactive bladder. However, the complexity of muscarinic receptor functions in the bladder and elsewhere in the body makes it difficult to predict the optimal profile of subtype selectivity for the treatment of bladder overactivity. Since M3 receptors are located not only in the bladder but also in the salivary glands and the intestine, the concept of selected M3 receptor antagonism may not offer a therapeutic advantage, since two of the most common side effects, dry mouth and constipation, would not be avoid. If the subtypes of receptors which mediate bladder contractions and those which produce the main side effects of the anti-muscarinic agents were entirely known, more effective agents with fewer side effects for the treatment of bladder overactivity might be obtainable. Pharmacologic treatment will be directed not only at function but at structure, and the concept of uroselectivity will assume greater importance.

목차

Abstract

Ⅰ. 과민성방광의 정의

Ⅱ. 역학

Ⅲ. 원인

Ⅳ. 진단

Ⅴ. 치료

Ⅵ. 결론

참고문헌

키워드

Overactive bladder Urgency Frequency Incontinence