{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T02:03:08Z","timestamp":1789437788576,"version":"build-2803163510"},"reference-count":40,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Overactive bladder (OAB) is an urgency\u2010based symptom syndrome that increases with aging in both sexes, but its explanations remain fragmented around benign prostatic hyperplasia\/bladder outlet obstruction in men, menopause\/estrogen loss in women, and metabolic, sleep\u2010related, or neurogenic mechanisms. We examine whether these diverse associations can be organized within a sex\u2010convergent mitochondrial\u2013oxidative framework while distinguishing OAB from urodynamic detrusor overactivity (DO) and broader lower urinary tract dysfunction (LUTD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This hypothesis\u2010generating Debate article was informed by a targeted narrative search of PubMed\/MEDLINE and citation chaining through August 2026. We prioritized direct human lower urinary tract studies, validated symptom or urodynamic phenotypes, causal animal models, and bladder intervention studies; evidence extrapolated from non\u2010bladder tissues was treated as indirect.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Evidence supports mitochondrial\u2013oxidative injury in selected bladder ischemia, obstruction, diabetes, aging, and sex\u2010hormone\u2010deprivation models, with limited human associations. Diverse upstream exposures may converge on candidate detrusor\u2013urothelial dysfunction, but direct comparative male\u2013female evidence is lacking. Sleep\u2013circadian\/endocrine disruption is the most speculative arm; autonomic dysregulation is considered a parallel, potentially interacting route rather than a consequence of mitochondrial dysfunction. Existing OAB treatments may also alter afferent, smooth\u2010muscle, or neural signaling. The framework therefore generates testable predictions rather than asserting a universal lesion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Age\u2010related OAB may be usefully examined through a bioenergetic framework that integrates detrusor, urothelial, vascular, metabolic, hormonal, and neural influences. Mitochondrial\u2013oxidative dysfunction should currently be regarded as a candidate contributor rather than a universal final pathway, requiring direct bladder\u2010level and sex\u2010comparative validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/nau.70445","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T01:56:32Z","timestamp":1789437392000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Overactive Bladder as a Bioenergetic Disorder: A Sex\u2010Convergent Mitochondrial\u2013Oxidative Framework"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9923-5747","authenticated-orcid":false,"given":"Yu\u2010Hsiang","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Urology, Linkou Chang Gung Memorial Hospital, and School of Medicine Chang Gung University Guishan Taoyuan 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