Pathogenesis of overactive bladder and surgical treatment according to the Integral Theory Paradigm

作     者：Peter Petros Peter Petros

作者机构：Formerly University of NSW Professorial Dept of SurgerySt Vincent’s Hospital SydneyAustralia School of Mechanical and Mathematical EngineeringUniversity of Western AustraliaPerthWAAustralia 

出 版 物：《Gynecology and Obstetrics Clinical Medicine》 (妇产科临床医学（英文）)

年 卷 期：2021年第1卷第2期

页      面：55-61页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：bladder treatment otherwise 

摘      要：Overactive bladder(OAB is a definition by the International Continence Society(ICS).It comprises three symptoms,urge,frequency and *** is a major problem for up to 30%of women,more so for elderly *** is generally assumed to be a paradigm,but it cannot meet the criteria of a paradigm,as its causation is said to beidiopathic(unknown)and is said to have no known *** 1993,it was demonstrated that the sequence of events in urodynamically diagnosed detrusor overactivity(nowDO)was identical with what occurred in normal micturition,which led to the conclusion that frequency,urgency,nocturia were in effect,an uncontrolled but otherwise normal *** from a 1997 experiment indicated the control mechanism of the bladder was binary,either closed or open,regulated by a peripheral musculoligamentous system under cortical *** Integral Theory paradigm s view of OAB is based on and is compatible with,ICS definitions and *** Integral Theory paradigm(ITP)views OAB pathogenesis as anatomical,caused by defects anywhere along the control mechanism pathway,but mainly damage in its weakest link,collagen defects in the peripheral musculoligamentous *** tests to prove causation consist of mechanically supporting suspensory ligaments,pubourethral ligament(PUL)or uterosacral ligament(USL),simulated operations;PUL support prevents urine loss on coughing;USL support by inserting the lower blade of a bivalve speculum into the vagina diminishes urge and *** ITP specifies treatment of correctible causes:squatting-based exercises to strengthen the reflex pelvic muscles,ligament repair by plication for premenopausal women,slings for postmenopausal women.