Traitement médical de l’hypoactivité vésicale
Tóm tắt
L’hypoactivité du détrusor, définie par l’existence d’une contraction détrusorienne, réduite en force ou en durée déterminant une vidange vésicale prolongée ou un défaut de vidange complète dans un temps habituel [1,2], demeure un problème thérapeutique imparfaitement résolu. Les différentes classes pharmacologiques ayant fait l’objet d’application thérapeutique dans l’hypoactivité du détrusor (HOD), agonistes cholinergiques, anticholinestérasiques et prostaglandines visent à renforcer les capacités contractiles cholinodépendantes du détrusor. La médiation non adrénocholinergique du réflexe mictionnel n’a pas fait l’objet de développement thérapeutique dans cette indication. Cette mise au point corrige les résultats des travaux cliniques contrôlés évaluant l’intérêt clinique et/ou urodynamiques des agents cholinomimétiques dans l’hypoactivité vésicale (HOV). Leur pertinence thérapeutique, préventive ou curative, en monothérapie n’apparaît pas établie et l’intérêt de la combinaison d’agents pharmacologiques reste à confirmer.
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