Abstract
This paper reviewed two common sources of elderly incontinence with brain etiologies, “vascular incontinence” (a disorder of bladder control resulting from cerebral white matter disease) and normal-pressure hydrocephalus (NPH), from a neurological point of view. Both diseases manifest with gait disturbance, dementia, and urinary incontinence. Urinary frequency/ urgency (overactive bladder, OAB) often precedes urinary incontinence in both diseases, and in some patients may be the initial manifestation. While NPH is less common than vascular incontinence, at approximately one-tenth the prevalence, it is important because the symptoms can be reversed by shunt surgery or endoscopic third ventriculostomy. For vascular incontinence, early identification of risk factors and initiation of secondary prevention are necessary. Detrusor overactivity due to frontal hypofunction may underlie the bladder disorder in both diseases. Treatment options for urinary incontinence include anticholinergics, which do not easily penetrate the blood-brain barrier, or newer drugs that act on the adrenergic beta-3 receptor and other receptors.
Keywords: Geriatric incontinence, white matter disease, normal-pressure hydrocephalus, overactive bladder, anticholinergic drug
Current Drug Therapy
Title:“Vascular Incontinence” and Normal-Pressure Hydrocephalus: Two Commonsources of Elderly Incontinence with Brain Etiologies
Volume: 7 Issue: 1
Author(s): Ryuji Sakakibara, Jalesh Panicker, Clare J. Fowler, Fuyuki Tateno, Masahiko Kishi, Yohei Tsuyusaki, Tomoyuki Uchiyama and Tatsuya Yamamoto
Affiliation:
Keywords: Geriatric incontinence, white matter disease, normal-pressure hydrocephalus, overactive bladder, anticholinergic drug
Abstract: This paper reviewed two common sources of elderly incontinence with brain etiologies, “vascular incontinence” (a disorder of bladder control resulting from cerebral white matter disease) and normal-pressure hydrocephalus (NPH), from a neurological point of view. Both diseases manifest with gait disturbance, dementia, and urinary incontinence. Urinary frequency/ urgency (overactive bladder, OAB) often precedes urinary incontinence in both diseases, and in some patients may be the initial manifestation. While NPH is less common than vascular incontinence, at approximately one-tenth the prevalence, it is important because the symptoms can be reversed by shunt surgery or endoscopic third ventriculostomy. For vascular incontinence, early identification of risk factors and initiation of secondary prevention are necessary. Detrusor overactivity due to frontal hypofunction may underlie the bladder disorder in both diseases. Treatment options for urinary incontinence include anticholinergics, which do not easily penetrate the blood-brain barrier, or newer drugs that act on the adrenergic beta-3 receptor and other receptors.
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Sakakibara Ryuji, Panicker Jalesh, J. Fowler Clare, Tateno Fuyuki, Kishi Masahiko, Tsuyusaki Yohei, Uchiyama Tomoyuki and Yamamoto Tatsuya, “Vascular Incontinence” and Normal-Pressure Hydrocephalus: Two Commonsources of Elderly Incontinence with Brain Etiologies, Current Drug Therapy 2012; 7 (1) . https://dx.doi.org/10.2174/157488512800389218
DOI https://dx.doi.org/10.2174/157488512800389218 |
Print ISSN 1574-8855 |
Publisher Name Bentham Science Publisher |
Online ISSN 2212-3903 |
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