臨床泌尿器科61巻8号

2007年07月発行

特集 過活動膀胱のすべて

過活動膀胱の病因と発生メカニズム

著者： 秋野裕信¹ 横山修¹

所属機関： ¹福井大学医学部泌尿器科学講座

ページ範囲：P.579 - P.584

要旨　過活動膀胱の病因は神経因性と非神経因性に大別され，代表的疾患としては神経因性で脳血管障害，パーキンソン病，認知症，多系統萎縮症，脊髄損傷，多発性硬化症が，非神経因性では前立腺肥大症などの下部尿路通過障害，加齢，骨盤底の脆弱化，特発性が挙げられる。これらの疾患が過活動膀胱を発生するメカニズムは多岐にわたるが，橋排尿中枢への脳内抑制性投射系の障害や促進性投射系の亢進，膀胱C線維を求心路とする排尿反射回路の再構築，膀胱平滑筋の脱神経過敏や尿路上皮からの各種メディエーターの放出などが関与すると考えられている。また，近年注目されている蓄尿期の膀胱収縮と過活動膀胱の発生との関連についても言及した。

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