Drug Treatment of Lower Urinary Tract Dysfunction in Women

Abstract

The lower urinary tract has two basic functions: storage of urine and emptying of urine. Voiding dysfunction is a broad term that results from disruption of any one of the factors listed earlier, essentially, a failure to store, a failure to empty, or any combination of these factors. LUT uropharmacology addresses the innervations and receptor contents of the bladder, urethra, and pelvic floor. Failure of the LUT to adequately fill and store urine may be secondary to pathology in the bladder, the outlet, or both. Physiological bladder contractions are thought to be primarily triggered by acetylcholine (ACh)-induced stimulation of postganglionic parasympathetic muscarinic cholinergic receptor sites on bladder smooth muscle. Some agents have been identified that have dual mechanisms of action. They have antimuscarinic activity and direct musculotropic relaxant effects on the bladder smooth muscle at a site metabolically distal to the antimuscarinic receptor.