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Van de Borne S, Tilborghs S, Vaganée D, Vermandel A, De Wachter S. Detailed Investigation of Bladder Diary Parameters During Sacral Neuromodulation in Patients With Overactive Symptoms. Neuromodulation 2023; 26:1831-1835. [PMID: 36266179 DOI: 10.1016/j.neurom.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/22/2022] [Accepted: 09/13/2022] [Indexed: 03/23/2023]
Abstract
AIMS Sacral neuromodulation (SNM) is a well-accepted, minimally invasive modality for patients with overactive bladder (OAB). Successful response to SNM is defined as at least 50% improvement in key symptoms, evaluated in a bladder diary (BD). BDs provide much useful information on bladder behavior during daily life. The aim of this study is to investigate BD parameter changes during SNM therapy in patients with OAB. MATERIALS AND METHODS The International Consultation on Incontinence Questionnaires (ICIQ)-BD was filled out by 34 patients with OAB, for three days at baseline and after three weeks of subthreshold sensory stimulation. The patients were considered responders for SNM when 50% improvement was seen in the BD. They underwent implantation of an internal pulse generator (IPG), and subsequently, an ICIQ-BD and a visual analog scale (VAS) evaluating bladder satisfaction during three days were filled out six weeks, six months, and one year after IPG implantation. RESULTS IPGs were implanted in 29 patients (85%). The BD showed a significant decrease in 24-hour leakage at three weeks from 4.2 to 0.6 (-86%, p < 0.001), similar significant decreases at six weeks and six months, and at one year (-80%). Voided volume (VV) at corresponding bladder sensation codes was not different between baseline and at three weeks of tined-lead procedure (TLP) (p > 0.05), and at six weeks (p > 0.05), six months (p > 0.1), and one year of IPG (p > 0.08). After three weeks of TLP, urgency episodes decreased from 4.8 to 3.4 (-30%, p = 0.025), with 59% reduction at six-weeks IPG (p < 0.001) and 49% at six-months IPG (p = 0.013). At one year, a decrease from 4.7 to 2.3 (52% reduction, p = 0.017) was noted. VAS showed the strongest correlation with urgency (p < 0.001) and frequency (p = 0.006). No significant correlation was found with VV (p = 0.87). CONCLUSIONS Our study describes how bladder sensation parameters change over time in patients on SNM. VV does not significantly increase, nor does frequency significantly decrease over the first year. Leaks and the percentage of urgency episodes significantly decrease, reaching a plateau level between six-weeks and six-months SNM.
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Affiliation(s)
- Sigrid Van de Borne
- Department of Urology, Antwerp University Hospital, Edegem, Belgium; Department of Urology, Antwerp Surgical Training, Anatomy and Research Centre, Faculty of Medicine and Health Sciences, Anatomy, University of Antwerp, Antwerp, Belgium
| | - Sam Tilborghs
- Department of Urology, Antwerp University Hospital, Edegem, Belgium; Department of Urology, Antwerp Surgical Training, Anatomy and Research Centre, Faculty of Medicine and Health Sciences, Anatomy, University of Antwerp, Antwerp, Belgium
| | - Donald Vaganée
- Department of Urology, Antwerp University Hospital, Edegem, Belgium; Department of Urology, Antwerp Surgical Training, Anatomy and Research Centre, Faculty of Medicine and Health Sciences, Anatomy, University of Antwerp, Antwerp, Belgium
| | - Alexandra Vermandel
- Department of Urology, Antwerp University Hospital, Edegem, Belgium; Faculty of Medicine and Health Sciences, Division of Occupational and Physical Therapy, University of Antwerp, Antwerp, Belgium
| | - Stefan De Wachter
- Department of Urology, Antwerp University Hospital, Edegem, Belgium; Department of Urology, Antwerp Surgical Training, Anatomy and Research Centre, Faculty of Medicine and Health Sciences, Anatomy, University of Antwerp, Antwerp, Belgium.
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López-Fando Lavalle L, Calleja Hermosa P, Velasco Balanza C, Jiménez Cidre M, Gutiérrez Baños JL, Viegas V, Sánchez Ramírez A, Esteban Fuertes M, Gutiérrez Ruiz C, Peri Cusí L, Castro Díaz D, Arlandis Guzmán S. Bladder Capacity in Women With Overactive Bladder Syndrome: A Cross-sectional Study. Urology 2023; 179:44-49. [PMID: 37353085 DOI: 10.1016/j.urology.2023.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 06/07/2023] [Accepted: 06/12/2023] [Indexed: 06/25/2023]
Abstract
OBJECTIVE To evaluate bladder capacity in women with idiopathic overactive bladder syndrome (OAB) through bladder diary, cystomanometry, and uroflowmetry and assess the concordance of the different measures of bladder capacity. A secondary objective is to describe the relationship between bladder capacity and urinary frequency in OAB patients. METHODS An observational cross-sectional multicentric study was conducted, including female patients diagnosed with idiopathic OAB. All participants underwent a urodynamic study and completed a 3-day bladder diary (3dBD). Different parameters were used to calculate bladder capacity: maximum cystometric capacity (MCC) assessed at the end of filling cystometry, voided volume (VV) during the uroflowmetry, maximum voided volume (VVmax), and average voided volume (VVmed), both assessed through the 3dBD. Reproducibility analysis was performed to assess the agreement among the different bladder capacity measures. Intraclass correlation coefficient (ICC) and weighted Kappa index were used. Bladder capacity parameters were also assessed in relation to urinary frequency. RESULTS Bladder capacity measures were diminished in this population, except for VVmax. Poor correlation was found between the different bladder capacity variables (ICC and weighted Kappa index <0.4). Twenty-four-hour frequency and average VV present a weak negative linear relationship (Pearson coefficient -0.344). CONCLUSION MCC and average VV are reduced in OAB patients. MCC does not correlate well with functional bladder volumes determined by voiding diary in the OAB population.
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Hentzen C, Chesnel C, Teng M, Blouet E, Le Breton F, Lagnau P, Miget G, Amarenco G. Influence of urodynamic conditions on bladder sensations and detrusor activity in patients with multiple sclerosis. Neurourol Urodyn 2022; 41:1898-1905. [PMID: 36098451 DOI: 10.1002/nau.25042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 08/08/2022] [Accepted: 08/31/2022] [Indexed: 11/08/2022]
Abstract
AIMS The study aimed to assess the impact of bladder filling rate and fluid temperature during urodynamics on bladder sensations and volume of apparition of detrusor overactivity in patients with multiple sclerosis (PwMS). METHODS Consecutive PwMS assessed with a standardized urodynamic test including three consecutive cystometries (20 ml/min, 100 ml/min, and 100 ml/min with 4°C fluid (Ice water test [IWT]) between June 2020 and March 2022 were included in this retrospective study. Data collected were bladder sensation with first desire to void (FDV) and strong desire to void (SDV). The presence of detrusor overactivity (DO) and the volume of the first uninhibited detrusor contraction were recorded. RESULTS One hundred and fifty-seven patients (mean age 47.4 ± 11.8 years, median EDSS 3 IQR[2-5], 73.9% of women) were included. Increased filling rate induced delayed bladder sensations (FDV 219 ± 109 ml vs. 194 ± 100 ml; SDV 349 ± 113 ml vs. 322 ± 124 ml for 100 ml/min and 20 ml/min filling rate, respectively, p < 0.001). Ice water increased bladder sensations with earlier reports of needs to void (FDV 163 ± 99 ml vs. 218 ± 117 ml; SDV 263 ± 104 ml vs. 351 ± 112 ml respectively; p < 0.001). Thirty-four patients had DO during both 20 ml/min and 100 ml/min fillings, without difference in the volume of apparition (p = 0.78). Forty-four patients had DO during both 100 ml/min and IWT. Detrusor overactivity appeared for a reduced volume during IWT compared with room temperature fluid perfusion (-68 ml [-95 to -41]; p < 0.001). CONCLUSION Filling rate and fluid temperature impact bladder sensations during cystometry in PwMS. Ice water decreased the volume of the first uninhibited detrusor contraction.
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Affiliation(s)
- Claire Hentzen
- GRC 01, GREEN Group of clinical REsEarch in Neurourology, AP-HP, Hôpital Tenon, Sorbonne University, Paris, France
| | - Camille Chesnel
- GRC 01, GREEN Group of clinical REsEarch in Neurourology, AP-HP, Hôpital Tenon, Sorbonne University, Paris, France
| | - Maëlys Teng
- GRC 01, GREEN Group of clinical REsEarch in Neurourology, AP-HP, Hôpital Tenon, Sorbonne University, Paris, France
| | - Emilie Blouet
- GRC 01, GREEN Group of clinical REsEarch in Neurourology, AP-HP, Hôpital Tenon, Sorbonne University, Paris, France
| | - Frederique Le Breton
- GRC 01, GREEN Group of clinical REsEarch in Neurourology, AP-HP, Hôpital Tenon, Sorbonne University, Paris, France
| | - Philippe Lagnau
- GRC 01, GREEN Group of clinical REsEarch in Neurourology, AP-HP, Hôpital Tenon, Sorbonne University, Paris, France
| | - Gabriel Miget
- GRC 01, GREEN Group of clinical REsEarch in Neurourology, AP-HP, Hôpital Tenon, Sorbonne University, Paris, France
| | - Gerard Amarenco
- GRC 01, GREEN Group of clinical REsEarch in Neurourology, AP-HP, Hôpital Tenon, Sorbonne University, Paris, France
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McCloskey KD, Wyndaele JJ, Speich JE, Birder L, Nelson PP. Should we be revisiting LUT basic science and clinical measurement of LUT sensation to improve patient care? ICI-RS 2019. Neurourol Urodyn 2020; 39 Suppl 3:S23-S29. [PMID: 32662560 DOI: 10.1002/nau.24273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 12/27/2019] [Indexed: 11/10/2022]
Abstract
AIMS This article reviews current knowledge of the underpinning mechanisms of how the bladder senses fullness locally and also revisits clinical measurements of lower urinary tract sensation. The former represents cellular sensing during bladder filling whereas the latter describes the sensations leading to conscious perception of bladder fullness. METHODS The topic was discussed in a "think tank" session at the 2019 International Consultation on Incontinence-Research Symposium in Bristol, UK; summarized in the present review. RESULTS Recent advances in the basic science of bladder sensing relating to (a) the bladder wall-urothelial cells, sensory nerves, interstitial cells, and smooth muscle cells and (b) putative chemo/mechanosensors in the urethra-paraneurons or "brush cells" are discussed. Validated clinical measurement of lower urinary tract sensation is reviewed in the context of how this could be better harnessed for patient benefit. We discuss the potential of app/tablet/mobile technology based on triggers and distractors to override aberrant local sensing/higher sensation and how these technologies could be utilized in treatment. CONCLUSIONS We conclude that a better understanding of bladder sensation is essential to inform clinical management of lower urinary tract symptoms.
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Affiliation(s)
- Karen D McCloskey
- Centre for Cancer Research and Cell Biology, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | | | - John E Speich
- Department of Mechanical and Nuclear Engineering, College of Engineering, Virginia Commonwealth University, Richmond, Virginia
| | - Lori Birder
- Departments of Medicine-Renal Electrolyte Division and Pharmacology/Chemical Biology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Pierre P Nelson
- Department of Physical Medicine and Rehabilitation, Hôpital Rothschild, Sorbonne Université, Paris, France
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Herrewegh AGM, Vrijens DMJ, Marcelissen TAT, van Koeveringe GA. Bladder sensations in male and female overactive bladder patients compared to healthy volunteers: a sensation-related bladder diary evaluation. Scand J Urol 2019; 53:255-260. [PMID: 31354017 DOI: 10.1080/21681805.2019.1641551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: To investigate the differences in bladder sensations of overactive bladder (OAB) patients compared to healthy volunteers. In addition, to see if bladder sensations are different in men and women.Methods: In a prospective, longitudinal study (METC 09-2-095), 66 volunteers and 68 OAB patients were included. Anticholinergic medication was stopped. Subjects filled out a sensation-related bladder diary (SR-BD), for two periods of 3 days, including a 4-points urgency scale and visual analogue scale for perception of bladder fullness.Results: In total, 6160 voids were assessed. Patients voided more often with higher degrees of urge at a lower mean voided volume (193 vs 270 ml/void; p < 0.001) than healthy volunteers. The mean urinary frequency per litre diuresis was also higher (5.8 vs 4.1/l; p < 0.001) in patients. At the same voided volume: patients perceived a higher mean bladder fullness, independent of the degree of urge, and higher urgency (1.4 vs 0.5/100 ml; p < 0.001) than healthy volunteers. There were no gender differences in the above-mentioned voiding parameters, except for the mean voided volume at urge 3 in volunteers (340 ml in men vs 362 ml in women; p = 0.03) and urge 1 in patients (171 ml in men vs 135 ml in women; p = 0.027).Conclusions: Bladder sensations were significantly increased in everyday life for both male and female OAB patients compared to healthy volunteers. OAB patients experienced a higher mean bladder fullness sensation, independent of the degree of urge, and higher mean urge/urgency at the same voided volume than volunteers. Bladder sensations are crucial in the assessment of treatment response.
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Affiliation(s)
- A G M Herrewegh
- Department of Urology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - D M J Vrijens
- Department of Urology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - T A T Marcelissen
- Department of Urology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - G A van Koeveringe
- Department of Urology, Maastricht University Medical Centre+, Maastricht, The Netherlands
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Medina Lucena H, Tincello DG. Methods of assessing and recording bladder sensation: a review of the literature. Int Urogynecol J 2018; 30:3-8. [PMID: 30187093 PMCID: PMC6510803 DOI: 10.1007/s00192-018-3760-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 08/21/2018] [Indexed: 12/13/2022]
Abstract
Introduction and hypothesis The objective was to review different methods that have been used to assess bladder sensation and to provide an overview of the accuracy and objectivity of the measurement of the subjective perception of the bladder. Methods The MEDLINE and PubMed databases were searched to identify articles. References from those articles were also searched. Terms used for the search were: urinary bladder, sensation, cystometry, urodynamics, urinary incontinence and focus group. Eight hundred and fifty abstracts were identified from databases, and 12 from other sources. Twenty-two duplicate articles were removed. Irrelevant articles were excluded after reading their titles. Fifty-four articles were eligible, but 17 were excluded after reading the full text, leaving 37 articles where assessment of bladder sensation was the main aim. Results Six different methods of measuring bladder sensation have been described in the literature. Although the most frequently used was cystometry, this is an invasive tool and does not reproduce bladder behaviour during daily life because it records bladder sensation as episodic events. The visual analogue scale using a forced diuresis protocol seemed to be an excellent tool. It was non-invasive and evaluated bladder sensation continuously, from an empty to a full bladder. Conclusions In some of the studies, the samples were too small to draw any significant conclusions. There were also conflicting data on which tool was the most accurate, especially as each method of evaluating bladder sensation may influence the way it is described by participants.
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Affiliation(s)
- Hayser Medina Lucena
- Department of Health Sciences, University of Leicester, Centre for Medicine, University Road, Leicester, Leicestershire, LE1 7RH, UK.
| | - Douglas G Tincello
- Department of Health Sciences, University of Leicester, Centre for Medicine, University Road, Leicester, Leicestershire, LE1 7RH, UK
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Medina Lucena H, Tincello DG. Validation of a water-load protocol to define the pattern of bladder sensation. Int Urogynecol J 2018; 30:767-772. [PMID: 30121702 PMCID: PMC6491398 DOI: 10.1007/s00192-018-3735-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 07/23/2018] [Indexed: 12/21/2022]
Abstract
Introduction and hypothesis The aim of this study was to confirm reliability of a water-load diuresis protocol and to assess the utility of bladder sensation curves. Methods For confirmation of fixed diuresis rate (phase 1), 12 volunteers consumed 250–300 ml of water every 15 min and recorded bladder sensation on a visual analogue scale (VAS) every 5 min to maximum sensation over two filling cycles: voids 1 and 2 (V1 and V2). The test was performed twice. For test–retest validation (phase 2), 24 participants underwent the same protocol drinking 300 ml of water every 15 min. Diuresis rates and voided volumes were compared between cycles and across tests. Results In phase 1, there was no difference in median void volume (V1 735 ml, V2 678 ml p = 0.433) or median diuresis rates (V2 12.1 ml/min, V3 14.4 ml/min p = 0.136) between cycles. When comparing those who drank 250–300 ml/15 min, there was less variability in those drinking 300-ml aliquots, so this was standardised for later experiments; 95% upper confidence limit of variability of the diuresis rate was calculated as 4.5 ml/min. Any test with a greater difference was rejected as invalid. In phase 2, only 16 participants were analysed. There was no difference in median void volumes between tests [V1 763 ml and 820 ml (p = 0.109) and V2 788 ml and 796 ml (p = 0.266)] or in diuresis rates between test 1 (12.33 ml/min) and 2 (14.40 ml/min) (p = 0.056). Median area under the curve was similar between test 1 404.96 and test 2 418.63. Conclusions This refined protocol reliably produced stable diuresis with a water load of 300 ml/15 min, excluding those with a difference in diuresis rate > 4.5 ml/min.
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Affiliation(s)
- Hayser Medina Lucena
- Department of Health Sciences, University of Leicester, Centre for Medicine, University Road, Leicester, Leicestershire, LE1 7RH, UK.
| | - Douglas G Tincello
- Department of Health Sciences, University of Leicester, Centre for Medicine, University Road, Leicester, Leicestershire, LE1 7RH, UK
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Rosier PF, Schaefer W, Lose G, Goldman HB, Guralnick M, Eustice S, Dickinson T, Hashim H. International Continence Society Good Urodynamic Practices and Terms 2016: Urodynamics, uroflowmetry, cystometry, and pressure-flow study. Neurourol Urodyn 2016; 36:1243-1260. [DOI: 10.1002/nau.23124] [Citation(s) in RCA: 257] [Impact Index Per Article: 32.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 05/13/2016] [Indexed: 01/11/2023]
Affiliation(s)
- Peter F.W.M Rosier
- Department of Urology; University Medical Center Utrecht; Utrecht The Netherlands
| | - Werner Schaefer
- Department of Medicine (Geriatrics); University of Pittsburgh; Pittsburgh Pennsylvania
| | - Gunnar Lose
- University of Copenhagen Herlev Hospital; Herlev Denmark
| | - Howard B. Goldman
- Glickman Urologic and Kidney Institute Cleveland Clinic; Lerner College of Medicine; Cleveland Ohio
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Veit-Rubin N, Cartwright R, Esmail A, Digesu GA, Fernando R, Khullar V. The location of pain and urgency sensations during cystometry. Neurourol Urodyn 2016; 36:620-625. [PMID: 26879227 DOI: 10.1002/nau.22975] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Accepted: 01/26/2016] [Indexed: 11/10/2022]
Abstract
AIMS The relationship between bladder pain and urinary urgency sensations is poorly understood. We analyzed the relationship between locations and intensities of urgency and pain sensations felt during filling cystometry. METHODS Participants completed the King's Health Questionnaire (KHQ) to indicate presence of bladder pain or urgency. During cystometry, participants scored the intensity of urgency and pain, both in the suprapubic and the urethral region, on a VAS scale of 0-10 at a baseline, at first desire, normal desire, strong desire to void, and at maximum cystometric capacity during filling. We allocated the participants to six groups; those reporting urgency or not, pain or not, both symptoms and neither. Friedman's Test was used to ascertain if all scores increased significantly, the Wilcoxon Signed Rank Test was used to demonstrate the difference between scores, and agreement for findings during cystometry was tested with Mann-Whitney U. RESULTS A total of 68 women participated; 38 participants reported pain, 57 reported urgency, and 33 reported both symptoms. Pain and urgency scores significantly increased during cystometry (P < 0.0001). For participants reporting pain, suprapubic pain was rated significantly higher than urethral pain. Participants reporting both symptoms, felt more urgency than pain, and again pain more suprapubically than urethrally. Participants reporting only urgency scored suprapubic and urethral urgency similarly at all desires. CONCLUSIONS Pain and urgency are well differentiated sensations and are felt at different locations although pain is seemingly easier localized. Neurourol. Urodynam. 36:620-625, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Nikolaus Veit-Rubin
- Department of Urogynaecology, St. Mary's Hospital, Imperial College London, London, United Kingdom
| | - Rufus Cartwright
- Department of Urogynaecology, St. Mary's Hospital, Imperial College London, London, United Kingdom
| | - Alisha Esmail
- Department of Urogynaecology, St. Mary's Hospital, Imperial College London, London, United Kingdom
| | - G Alessandro Digesu
- Department of Urogynaecology, St. Mary's Hospital, Imperial College London, London, United Kingdom
| | - Ruwan Fernando
- Department of Urogynaecology, St. Mary's Hospital, Imperial College London, London, United Kingdom
| | - Vikram Khullar
- Department of Urogynaecology, St. Mary's Hospital, Imperial College London, London, United Kingdom
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Joussain C, Parratte B, Gremeaux V, Dompeyre P. [Clinical and paraclinical evaluations of bladder sensitivity. Review of the literature]. Prog Urol 2014; 24:495-500. [PMID: 24875568 DOI: 10.1016/j.purol.2014.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 01/28/2014] [Accepted: 02/12/2014] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The aim of this work was to carry out a review of the literature on the clinical and paraclinical evaluation of bladder sensory (BS) to better understand BS disorders in nonneurological patients. METHODS Thirty-three articles were selected from the Medline(®) Database between 1992 and 2012 using the following key words: "sensory/sensitivity bladder evaluation", "sensory/sensitivity bladder scale", "sensory/sensitivity bladder questionnaire", "urodynamic bladder sensory", "urgency questionnaire" and "Overactive Bladder (OAB) questionnaire". RESULTS Evaluation of BS by asking questions during cystometry is validated (LE 2). The sensation of the desire to void progresses linearly with bladder filling (LE 2). Many symptoms and quality of life questionnaires related to BS anomalies have been proposed. Bladder diaries, frequency/volume curves (LE 2) and clinical algorithms (LE 3) could be an alternative to evaluate BS. CONCLUSION Current evaluation only provides a partial view of BS. A multidimensional approach should lead to better understanding of BS disorders.
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Affiliation(s)
- C Joussain
- Service de médecine physique et de réadaptation, centre hospitalier universitaire de Dijon, 21000 Dijon, France.
| | - B Parratte
- Service de médecine physique et de réadaptation, centre hospitalier universitaire, 25030 Besançon, France
| | - V Gremeaux
- Service de médecine physique et de réadaptation, centre hospitalier universitaire de Dijon, 21000 Dijon, France
| | - P Dompeyre
- Service de gynécologie-obstétrique, centre hospitalier Poissy-St-Germain-en-Laye, 78303 Poissy, France; Laboratoire privé d'explorations urodynamiques, 78300 Poissy, France
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Zeren MF, Yüksel MB, Temeltas G. The comparison of urodynamic findings ?n women with various types of urinary ?ncontinence. Int Braz J Urol 2014; 40:232-9. [DOI: 10.1590/s1677-5538.ibju.2014.02.14] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 11/25/2013] [Indexed: 11/22/2022] Open
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Rosier PF. The evidence for urodynamic investigation of patients with symptoms of urinary incontinence. F1000PRIME REPORTS 2013; 5:8. [PMID: 23513180 PMCID: PMC3590786 DOI: 10.12703/p5-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Urodynamic studies are the gold standard to objectively diagnose dysfunction of the lower urinary tract. The widely available evidence for the clinical relevance is, however, fragmented. This article summarizes the published knowledge supporting the use of urodynamic studies in urinary incontinence in female, male and frail patients, as well as patients with relevant neurological disease. Five technological innovations are discussed briefly. Standard urodynamic cystometry can, on the basis of a solid body of evidence, objectively unveil the entire function of the lower urinary tract in all patients with urinary incontinence, regardless of the patients' perception of (ab-)normality of signs and or symptoms.
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Affiliation(s)
- Peter F Rosier
- University Medical Centre Utrecht, Department of UrologyC 04.236, P.O. Box 85500, 3580GA UtrechtThe Netherlands
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Birder L, Wyndaele JJ. From urothelial signalling to experiencing a sensation related to the urinary bladder. Acta Physiol (Oxf) 2013; 207:34-9. [PMID: 23110490 DOI: 10.1111/apha.12011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2011] [Revised: 12/22/2011] [Accepted: 09/10/2012] [Indexed: 02/02/2023]
Abstract
The mechanisms underlying bladder sensation and the way we experience sensations during normal voiding and in pathology is complex and not well understood. During storage and emptying, mechanical changes occurring in number of cell types within the bladder wall (i.e. the uroepithelium and bladder afferents) can have a major influence on our sensory systems. In this review, we discuss bladder sensation with a focus on coding events in the periphery.
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Affiliation(s)
- L. Birder
- Departments of Medicine and Pharmacology; University of Pittsburgh School of Medicine; Pittsburgh; PA; USA
| | - J.-J. Wyndaele
- Antwerp University and Antwerp University Hospital; Antwerp; Belgium
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Harvey J, Finney S, Stewart L, Gillespie J. The relationship between cognition and sensation in determining when and where to void: the concept of cognitive voiding. BJU Int 2012; 110:1756-61. [DOI: 10.1111/j.1464-410x.2012.11078.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Heeringa R, van Koeveringe GA, Winkens B, van Kerrebroeck PEV, de Wachter SGG. Degree of urge, perception of bladder fullness and bladder volume--how are they related? J Urol 2011; 186:1352-7. [PMID: 21855937 DOI: 10.1016/j.juro.2011.05.050] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2011] [Indexed: 10/17/2022]
Abstract
PURPOSE We evaluated the reliability of the degree of urge and perception of bladder fullness scales, the relationship between the scales and bladder volume, and possible differences between bladder sensations experienced in a controlled or an uncontrolled setting. MATERIALS AND METHODS Volunteers and patients with overactive bladder symptoms participated in the protocols. They were asked to grade bladder sensation on a 4-point urge scale of no sensation to need to void now and assess the perception of fullness on a visual analog scale of empty to full bladder. This was assessed in a 3-day bladder diary and during controlled, noninvasive bladder filling. RESULTS Each scale was reliable and significantly related to bladder volume (p <0.001). Agreement between the scales and voided volume was poor. Patients and volunteers grade bladder fullness and degree of urge higher in an uncontrolled than in a controlled setting. CONCLUSIONS The perception of bladder fullness and the degree of urge have a significant relation to bladder volume in controlled and uncontrolled settings. Due to poor agreement between the scales and actual voided volume these scales cannot replace measuring voided volume. The perception of bladder sensation depends on the setting. Bladder sensation at the hospital might underestimate the bother of symptoms experienced by a patient in daily life.
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Affiliation(s)
- Rhea Heeringa
- Department of Urology, Maastricht University Medical Centre, Maastricht University, Maastricht, The Netherlands
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De Wachter SG, Heeringa R, van Koeveringe GA, Gillespie JI. On the nature of bladder sensation: the concept of sensory modulation. Neurourol Urodyn 2011; 30:1220-6. [PMID: 21661031 DOI: 10.1002/nau.21038] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2010] [Accepted: 10/22/2010] [Indexed: 01/23/2023]
Abstract
AIMS Going to the toilet is an essential everyday event. Normally, we do not give much thought to the sensations and factors that trigger voiding behavior: we just go. For many people, this apparently simple task is complicated and dominates their life. They have strong sensations and sudden desires to void, often resulting in incontinence. It is therefore important that we understand the origins for this functional change and identify means to alleviate it. METHODS Literature survey. RESULTS A considerable body of work has focused on this problem and ideas and concepts on the nature of bladder sensations are embedded in the literature. In this paper we argue the necessity to return to first principles and a re-examination of the problem. We explore the use of focus groups to identify relevant bladder sensation and what triggers 'bladder' behavior. We argue that there are differences in what can be described as 'introspective bladder sensations' and the sensations reported immediately before a void, 'void sensations'. Finally, we propose an alternative model describing how peripheral information generating 'introspective sensations' and 'void sensations' might be different but interrelated sensations. By exploring such ideas and identifying such complexity it is our intention to stimulate debate and generate further research in the field in order to understand better the physiology of bladder sensation and the pathology of increased urge, frequency and incontinence. CONCLUSIONS Review of the literature on bladder sensation and the established ideas suggests that we might be missing something and the problem of normal and increased sensation and of urgency may be much more complex.
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Affiliation(s)
- S G De Wachter
- Department of Urology, Maastricht University Medical Center, Maastricht, The Netherlands.
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Van Meel TD, Wyndaele JJ. Reproducibility of urodynamic filling sensation at weekly interval in healthy volunteers and in women with detrusor overactivity. Neurourol Urodyn 2011; 30:1586-90. [DOI: 10.1002/nau.21100] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2010] [Accepted: 02/09/2011] [Indexed: 11/06/2022]
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Honjo H, Kawauchi A, Nakao M, Ukimura O, Kitakoji H, Miki T. Impact of convenience void in a bladder diary with urinary perception grade to assess overactive bladder symptoms: A community-based study. Neurourol Urodyn 2010; 29:1286-9. [DOI: 10.1002/nau.20874] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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