排尿神经生理学:防止管理不当的叙述性综述。

IF 4.5 3区 医学 Q1 UROLOGY & NEPHROLOGY
Ricardo C Mattos, Luciano A Favorito
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引用次数: 0

摘要

导言:下尿路(LUT)功能的复杂性、可能破坏下尿路功能的疾病的流行病学以及相关症状的非特异性表现,这三个关键因素之间隐秘的相互关系凸显了了解下尿路神经控制的迫切需要。本文探讨了了解排尿神经生理学对防止误诊和减少不必要手术的重要性:本综述重点关注排尿周期的神经生理学、影响排尿周期的主要健康状况的流行病学以及与潜在病理有关的下尿路症状(LUTS)的非特异性。综述是根据叙事性综述文章评估量表(SANRA)的指导原则进行的。只纳入了英文文章,而病例报告、社论和专家意见文章则被排除在外:LUT 储存和释放尿液的能力需要精确的协调,并由一个涉及大脑、脊髓、外周神经节和神经的复杂网络介导。流行病学数据显示,影响 LUT 功能(LUTF)的疾病在全球造成的负担越来越重。此外,LUTS 的非特异性往往导致诊断困难和治疗策略不当:结论:LUTF 的复杂性、可破坏 LUTF 的疾病的广泛流行性以及相关症状的非特异性之间的相互作用常常使泌尿科的决策变得复杂。忽视相关的神经因素会导致治疗效果不理想、生活质量下降以及严重的不良后果。系统化的方法对于最大限度地降低误诊和误治的风险至关重要,尤其是在考虑采取侵入性干预措施时。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Neurophysiology of Micturition: a Narrative Review on Preventing Mismanagement.

Neurophysiology of Micturition: a Narrative Review on Preventing Mismanagement.

Neurophysiology of Micturition: a Narrative Review on Preventing Mismanagement.

Neurophysiology of Micturition: a Narrative Review on Preventing Mismanagement.

Introduction: The insidious interrelation between three key factors underscores the critical need to understand the neural control of the lower urinary tract (LUT): the complexity of its functioning, the epidemiology of conditions that can disrupt it, and the nonspecific presentation of related symptoms. This paper examines the importance of understanding neurophysiology of micturition to prevent mismanagement and reduce unnecessary procedures.

Material and methods: This review focuses on the neurophysiology of the micturition cycle, the epidemiology of major health conditions that affect it, and the nonspecific nature of lower urinary tract symptoms (LUTS) concerning underlying pathologies. The review was conducted in accordance with the guidelines of the Scale for Assessment of Narrative Review Articles (SANRA). Only articles in English were included, while case reports, editorials, and expert opinion pieces were excluded.

Results: The ability of the LUT to store and release urine requires precise coordination and is mediated by a complex network involving the brain, spinal cord, peripheral ganglia, and nerves. Epidemiological data reveal a growing global burden of diseases that impact LUT functioning (LUTF). Moreover, the nonspecific nature of LUTS often leads to diagnostic challenges, and inappropriate treatment strategies.

Conclusion: The interplay between the complexity of LUTF, the widespread prevalence of conditions that can disrupt it, and the nonspecific nature of related symptoms frequently complicate urological decision-making. Overlooking associated neurological factors can result in suboptimal outcomes, diminished quality of life, and serious adverse consequences. A systematic approach is crucial to minimizing the risk of misdiagnosis and mismanagement, especially when considering invasive interventions.

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来源期刊
International Braz J Urol
International Braz J Urol UROLOGY & NEPHROLOGY-
CiteScore
4.60
自引率
21.60%
发文量
246
审稿时长
6-12 weeks
期刊介绍: Information not localized
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