Overactive bladder (OAB) is still a serious problem because of its high prevalence in men and women. Endoscopic or open detrusor biopsies were obtained from 28 (24 male and 4 female) patients of 52 to 75 years of age with obstructive or idiopathic OAB of 1 to 10 year duration. The control group included 6 males and 2 females without OAB symptoms. Allergic inflammation with involvement of mast cells, parasympathetic element hyperplasia, ultrastructural changes of myocytes with structural damage to mitochondria were detected in the detrusor of patients with both obstructive and idiopathic OAB. Succinate dehydrogenase activity was low but lactate dehydrogenase activity was enhanced in lymphocytes of peripheral blood. Severity of these changes correlated with morphological features of decreased tissue respiration in the detrusor muscles. In view of the detected inflammatory pathogenetic aspects it is recommended to add antiallergic drugs improving detrusor bioenergetics to combined treatment of OAB.
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