ABSTRACT

Voiding dysfunction is a broad term that results from disruption of any one of the factors listed earlier, essentially, a failure store, a failure to empty, or any combination of these factors. Likewise, all treatments of voiding dysfunction can be classified under the categories of facilitating urinary storage or facilitating urinary emptying. These actions are achieved pharmacologically primarily by acting selectively or nonselectively on bladder smooth muscle or bladder outlet smooth or striated muscle. As a result of advances in the fields of neuropharmacology and neurophysiology of the LUT, effective pharmacological therapy now exists for the management of many categories of voiding dysfunction. In fact, in some categories, so many drug therapies are available for use with varying quality and quantity of research performed on them, and the international consultation on incontinence has assessed and made recommendations on many of the available agents (tables 46.1 [updated] and 46.2 [updated]). The clinical drug recommendations are based on evaluations made using a modification of the oxford system (table 46.3).