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Myogenic Underactive Bladder and Heart Failure Resemblance: A Novel Role for SGLT2 Inhibition?

The heart and bladder share physiological biomechanical determinants of contraction. Heart failure (HF) and myogenic underactive bladder (mUAB) also share similarities in their pathophysiology. In both cases there is muscle injury that is directly linked to disease stage. In the final stage, both myocardium and detrusor show marked fibrosis and lower contractility. While HF has an established pharmacological treatment, there are still no effective drugs for mUAB. This mini-review explores the similarities between HF and mUAB and suggests that, as in HF, SGLT2 inhibitors may also have a beneficial role in mUAB.

Patient summary: To date, there is no treatment for underactive bladder caused by problems with the bladder muscle (mUAB). We review similarities between this condition and heart failure and hypothesize that a recent drug class with striking results in heart failure might also have a beneficial role in mUAB.

Gabriel Faria-Costa, Ana Charrua, Carlos Martins-Silva,  Adelino Leite-Moreira, Tiago Antunes-Lopes

Department of Urology, Local Health Unit of Matosinhos, Matosinhos, Portugal; Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal; Cardiovascular Research and Development Center, Faculty of Medicine, University of Porto, Porto, Portugal; Department of Biomedicine-Unit of Experimental Biology, Faculty of Medicine of University of Porto, Porto, Portugal; Institute of Investigation and Innovation in Health, University of Porto, Porto, Portugal; Department of Urology, University Hospital Center São João, Porto, Portugal; Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal; Department of Biomedicine-Unit of Experimental Biology, Faculty of Medicine of University of Porto, Porto, Portugal; Institute of Investigation and Innovation in Health, University of Porto, Porto, Portugal; Department of Urology, University Hospital Center São João, Porto, Portugal; Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal; Cardiovascular Research and Development Center, Faculty of Medicine, University of Porto, Porto, Portugal; Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal; Department of Biomedicine-Unit of Experimental Biology, Faculty of Medicine of University of Porto, Porto, Portugal; Institute of Investigation and Innovation in Health, University of Porto, Porto, Portugal; Department of Urology, University Hospital Center São João, Porto, Portugal

Source: Faria-Costa G. et al. "Myogenic Underactive Bladder and Heart Failure Resemblance: A Novel Role for SGLT2 Inhibition?" European Urology Focus. 2022. volume 8, issue 6, P1783-1786.