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neurogenic basis of OAB (neurogenic mechanisms (reduction in peripheral or…
neurogenic basis of OAB
triggering events
damage to brain
reduces suprapontine inhibition
damage to axonal pathways in spinal cord
leads to emergence of primitive spinal reflexes mediated by C fibres
decreased central delay in micturition reflex
muscarine presynaptic modulatory mechanisms modified
in paraplegic patients spinal reflexes also lead to tonic sphincter activity thus increase in residual volume
afferent nerve hypertrophy
outlet obstruction
urethral ligation
bladder hypertrophy
facilitation of spinal pathway
increase in NGF
enlargement of afferent terminals
alteration of ion channels in
neurogenic mechanisms
reduction in peripheral or central inhibiton
enhancement of excitatory transmission in micturition reflex pathway
increased afferent input from LUT
emergence of bladder reflexes that are resistant to central inhibition