Lower Urinary Tract Symptoms and Aging: The Impact of Chronic Bladder Ischemia on Overactive Bladder Syndrome

Introduction: The overactive bladder syndrome (OAB) is one of the most common and bothersome subsets of lower urinary tract symptoms (LUTS), affecting predominantly the aged population, with a worldwide distribution. This syndrome has not been completely understood, yet the aging process and the decreased blood flow to the bladder have been highlighted as closely related to this phenomenon. Materials and Methods: We performed a search on the online database PubMed/MEDLINE with the following MESH terms: 'Overactive Bladder AND (Ischemia OR Aging OR Vascular Disease)'. We considered manuscripts written in English and published in the last 10 years (2004-2014, October). Additional manuscripts, such as referenced by reviews, were further included. Results: The aging process and the structural and functional changes resulting from an ischemic process emerge as important features that contribute to OAB. The ischemic-induced molecular and structural modifications that occur in the bladder have only recently been the objective of thorough studies, which link cardiovascular risk factors, vascular lesions and OAB. New animal models are being created to test new areas of treatment or prevention of ischemic-induced bladder dysfunction. Conclusion: Recent data point out that several physiological and pathological modifications that occur in the bladder associated with OAB and aging are closely related to ischemia. (C) 2015 S. Karger AG, Basel