The role of genetic polymorphisms and growth factors in pathogenesis of urgent and mixed urinary incontinence in women


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Abstract

The purpose of study. To analyze genetic polymorphisms of receptors of bladder, structural components of intercellular matrix of urinary excretion organs, molecular biochemical mechanisms of regulation of function of bladder and urethra resulting in urinary incontinency. Materials and methods. The analysis of publication data concerning genetic polymorphisms and molecular biochemical mechanisms of development of urinary incontinence in women. The results. The publication data is presented concerning impact of genetic polymorphisms of receptors of detrusor on development of urgent and mixed urinary incontinency in women. The corresponding molecular genetic and biochemical processes underlying detrusor sphincter dyssynergia in women are considered. Conclusion. The urinary incontinence is a multifactorial pathology developing due to alterations at systemic, organic, tissular and cellular levels. Such growth factors as bFGF, TGFβ, CTGF contribute into pathogenesis of urgent and partially mixed urinary incontinency resulting in intensification of unstripped muscle cohesions of detrusor, obstructive miohypertrophy and fibrosis of bladder wall. The altered adrenalin reactivity of urinary excretion ways plays particular role in pathogenesis of urgent component of urinary incontinence. And vice versa, damage of structure of connective tissue in patients with polymorphism COL1A1 or disorder of molecular biochemical mechanism of action of cytokines TGFβ and CTGF provoke insufficiency of sphincter apparatus of urinary excretion ways. The totality of enumerated mechanisms results in development of stress urinary incontinency. The elaboration of individual approach to selection of treatment method requires consideration of mentioned mechanisms of development of urinary incontinence including form and severity of disease.

About the authors

Tatyana Yu. Smolnova

The A.E. Evdokimov Moscow state medical stomatological university; The I.M. Sechenov first Moscow state medical university of Minzdrav of Russia

Email: smoltat@list.ru
doctor of medical sciences, associate professor of chair of reproductive medicine and surgery of the A.E. Evdokimov Moscow state medical stomatological university; senior research worker of department of operative gynecology the academician V.I. Kulakov research center of obstetrics, gynecology and perinatology of Minzdrav of Russia 127473, Moscow

D. M Lukyanova

The I.M. Sechenov first Moscow state medical university of Minzdrav of Russia

119992, Moscow, Russian Fedration

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