Department of Urology, Kumamoto Hospital of Japan Labor Health and Welfare Organization, 3-30-34-1402 Suizenji, Kumamoto, 862-0950, Japan.
World J Urol. 2009 Dec;27(6):729-37. doi: 10.1007/s00345-009-0491-0. Epub 2009 Nov 11.
Overactive bladder (OAB) represents a disruption in the storage function of the lower urinary tract. This bothersome condition occurs more commonly in the elderly. Since population forecasts predict a worldwide increase in the proportion of people aged over 65 years, it is reasonable to expect that the healthcare burden associated with OAB will also increase. The pathophysiology of OAB in the elderly is thought to be multifactorial, with an abnormality occurring in the nervous supply and/or the structure/function of the urothelium or bladder smooth muscle, leading to bladder hypersensitivity, abnormalities in bladder sensation (urgency) and involuntary detrusor contraction.
A review of some of the key aspects relating to management of this growing population was undertaken.
The potential for an elderly patient to present with a number of concomitant conditions means that careful characterization of their overall status is required before deciding on the most appropriate management option for their urinary tract pathology. Lifestyle interventions and pharmacological agents have shown success in treating OAB in the elderly, but as this patient group often has many concomitant conditions they are more likely to be seen by a non-urology specialist.
It is therefore important to raise awareness of the condition and an appreciation of its impact among healthcare professionals to ensure the most appropriate care.
膀胱过度活动症(OAB)代表下尿路储存功能障碍。这种令人困扰的疾病在老年人中更为常见。由于人口预测显示全球 65 岁以上人口比例增加,因此可以合理地预期与 OAB 相关的医疗保健负担也会增加。老年人 OAB 的病理生理学被认为是多因素的,在神经供应和/或尿路上皮或膀胱平滑肌的结构/功能中出现异常,导致膀胱过度敏感、膀胱感觉异常(尿急)和不随意逼尿肌收缩。
对与这一不断增长的人群管理相关的一些关键方面进行了回顾。
老年患者可能存在多种并存疾病,因此在决定最适合其尿路病理的管理方案之前,需要对其整体状况进行仔细描述。生活方式干预和药物治疗已成功治疗老年 OAB,但由于该患者群体通常存在许多并存疾病,他们更有可能由非泌尿科专家就诊。
因此,重要的是要提高医疗保健专业人员对该病症的认识和对其影响的认识,以确保提供最适当的护理。