Hypersensitive or Detrusor Overactivity: Which is Associated with Filling Symptoms in Female Bladder Outlet Obstructed Patients?
Vol. 16 No. 3 (2019),
17 June 2019
Purpose: To investigate and compare detrusor overactivity (DO) and bladder filling sensation characteristics in female bladder outlet obstruction (FBOO) patients with or without overactive bladder (OAB) symptoms.
Materials and Methods: One hundred fifty-seven FBOO patients with urodynamic testing were recruited. Patients who showed urinary urgency ( ? 6 episodes/3 d), with or without urinary frequency ( ?8 voids/24 h), and urge incontinence ( ? 3 episodes/3 d) were considered to have OAB. The detrusor overactivity (DO) and bladder filling sensation measures including first sensation (FSF), first desire to void (FDV) and strong desire to void (SDV) during filling cystometry were recorded. The associations between urodynamic variables and OAB symptoms were analysed.
Result: FBOO patients had a high incidence (79%) of OAB. FBOO patients with OAB symptoms had significantly younger age, higher incidence of DO (19.4% versus 6.1%) (P = .051) and lower bladder volumes of FSF (180.32 ± 83.48 versus 226.18 ± 100.90 mL), FDV (269.00 ± 109.78 versus 330.45 ± 123.95 mL) and SDV (345.56 ± 135.43 versus 422.33 ± 148.40 mL) (P < .05) compared to patients without OAB. In multivariate analyses, both DO (OR = 4.83, 95% CI: 1.02-22.85, P = .047) and lower bladder volumes at FDV(OR = 2.47, 95% CI: 1.03-5.95, P = .044) and SDV (OR = 3.07, 95% CI: 1.25-7.55, P < .014) were still independently associated with OAB, after adjustment for age and other confounding factors.
Conclusion: FBOO patients had a high incidence of OAB. Not only DO but also bladder hypersensitivity were independently associated with OAB symptoms in FBOO patients.
How to Cite
Chassagne, S., Bernier, P. A., Haab, F., Roehrborn, C. G., Reisch, J. S., Zimmern, P. E. Proposed cutoff values to define bladder outlet obstruction in women. Urology 1998; 51: 408-11
Nitti, V. W., Tu, L. M., Gitlin, J. Diagnosing bladder outlet obstruction in women. J Urol 1999; 161: 1535-40
Blaivas, J. G., Groutz, A. Bladder outlet obstruction nomogram for women with lower urinary tract symptomatology. Neurourol Urodyn 2000; 19: 553-64
Choi, Y. S., Kim, J. C., Lee, K. S.et al. Analysis of female voiding dysfunction: a prospective, multi-center study. Int Urol Nephrol 2013; 45: 989-94
Abdel-Aziz, K. F., Lemack, G. E. Overactive bladder in the male patient: bladder, outlet, or both? Curr Urol Rep 2002; 3: 445-51
Herbison, P., Hay-Smith, J., Ellis, G., Moore, K. Effectiveness of anticholinergic drugs compared with placebo in the treatment of overactive bladder: systematic review. BMJ 2003; 326: 841-44
Lee, S. R., Kim, H. J., Kim, A., Kim, J. H. Overactive bladder is not only overactive but also hypersensitive. Urology 2010; 75: 1053-59
Rapp, D. E., Neil, N. J., Govier, F. E., Kobashi, K. C. Bladder sensation measures and overactive bladder. J Urol 2009; 182: 1050-54
Abrams, P., Cardozo, L., Fall, M.et al: The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society, 年份, vol. 61; pp. 37-49
Lin, C. D., Kuo, H. C., Yang, S. S. Diagnosis and Management of Bladder Outlet Obstruction in Women. Low Urin Tract Symptoms 2016; 8: 30-37
Digesu, G. A., Khullar, V., Cardozo, L., Salvatore, S. Overactive bladder symptoms: do we need urodynamics? Neurourol Urodyn 2003; 22: 105-08
Yamaguchi, O., Honda, K., Nomiya, M.et al. Defining overactive bladder as hypersensitivity. Neurourol Urodyn 2007; 26: 904-07
van Brummen, H. J., Heintz, A. P., van der Vaart, C. H. The association between overactive bladder symptoms and objective parameters from bladder diary and filling cystometry. Neurourol Urodyn 2004; 23: 38-42
Roosen, A., Chapple, C. R., Dmochowski, R. R.et al. A refocus on the bladder as the originator of storage lower urinary tract symptoms: a systematic review of the latest literature. Eur Urol 2009; 56: 810-19
Johansson, R. K., Poljakovic, M., Andersson, K. E., Persson, K. Expression of nitric oxide synthase in bladder smooth muscle cells: regulation by cytokines and L-arginine. J Urol 2002; 168: 2280-85
Zhou, Y., Ling, E. A. Increased NADPH-diaphorase reactivity in bladder afferent pathways following urethral obstruction in guinea pigs. J Peripher Nerv Syst 1997; 2: 333-42
Steers, W. D., De Groat, W. C. Effect of bladder outlet obstruction on micturition reflex pathways in the rat. J Urol 1988; 140: 864-71
Heppenstall, P. A., Lewin, G. R.: Neurotrophins, nociceptors and pain, 2000, vol. 13; pp. 573-76
Steers, W. D., Kolbeck, S., Creedon, D., Tuttle, J. B. Nerve growth factor in the urinary bladder of the adult regulates neuronal form and function. J Clin Invest 1991; 88: 1709-15
Chapple, C. Chapter 2: Pathophysiology of neurogenic detrusor overactivity and the symptom complex of "overactive bladder". Neurourol Urodyn 2014; 33 Suppl 3: S6-13
Akikwala, T. V., Fleischman, N., Nitti, V. W. Comparison of diagnostic criteria for female bladder outlet obstruction. J Urol 2006; 176: 2093-97
- Abstract Viewed: 395 times
- PDF/4362 Downloaded: 220 times