Overactive bladder, inflammation and urinary tract infection: pathogenetic parallels

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.