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Funayama M, Koreki A, Takata T, Nakagawa Y, Mimura M. Post-stroke urinary incontinence is associated with behavior control deficits and overactive bladder. Neuropsychologia 2024; 201:108942. [PMID: 38906459 DOI: 10.1016/j.neuropsychologia.2024.108942] [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: 10/26/2023] [Revised: 05/17/2024] [Accepted: 06/18/2024] [Indexed: 06/23/2024]
Abstract
BACKGROUND Although urinary incontinence in stroke survivors can substantially impact the patient's quality of life, the underlying neuropsychological mechanisms and its neural basis have not been adequately investigated. Therefore, we investigated this topic via neuropsychological assessment and neuroimaging in a cross-sectional study. METHODS We recruited 71 individuals with cerebrovascular disease. The relationship between urinary incontinence and neuropsychological indices was investigated using simple linear regression analysis or Mann-Whitney U test, along with other explanatory variables, e.g., severity of overactive bladder. Variables with a p-value of <0.1 in the simple regression analysis were entered in the final multiple linear regression model to control for potential confounding factors. To carry out an in-depth examination of the neuroanatomical substrate for urinary incontinence, voxel-based lesion-behavior mapping was performed using MRIcron software. RESULTS Behavioral control deficits and severity of overactive bladder were closely related to severity of urinary incontinence. The voxel-based lesion-behavior mapping suggests a potential role for ventromedial prefrontal cortex lesioning in the severity of urinary incontinence, although this association is not statistically significant. CONCLUSIONS Post-stroke urinary incontinence is closely related to two factors: neurogenic overactive bladder, a physiological disinhibition of micturition reflex, and cognitive dysfunction, characterized by behavior control deficits.
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Affiliation(s)
- Michitaka Funayama
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Ashikaga, Tochigi, 326-0843, Japan; Department of Rehabilitation, Edogawa Hospital, Edogawa, Tokyo, 133-0052, Japan; Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, 160-0016, Japan.
| | - Akihiro Koreki
- Department of Psychiatry, National Hospital Organization Shimofusa Psychiatric Medical Center, Chiba, 266-0007, Japan
| | - Taketo Takata
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Ashikaga, Tochigi, 326-0843, Japan
| | - Yoshitaka Nakagawa
- Department of Rehabilitation, Edogawa Hospital, Edogawa, Tokyo, 133-0052, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, 160-0016, Japan
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Zhang Y, Song J, Li B, Wu Y, Jia S, Shu H, Liu F, Yang X. Association between body roundness index and overactive bladder: results from the NHANES 2005-2018. Lipids Health Dis 2024; 23:184. [PMID: 38867211 PMCID: PMC11167800 DOI: 10.1186/s12944-024-02174-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 06/02/2024] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND AND AIM An increasing amount of research has indicated obesity greatly affects individuals with overactive bladder (OAB). However, traditional anthropometric methods present challenges in accurately assessing the likelihood of OAB. Hence, this study's objective was to identify the correlation between the body roundness index (BRI) and OAB. METHODS The research included 12,401 individuals who participated in the National Health and Nutrition Examination Survey spanning 2005-2018. The correlation between BRI and OAB was explored by using weighted multiple logistic regression and weighted restricted cubic spline (RCS). Subgroup analyses showed the associations based on different population types. The study also analyzed the predictive capability of various anthropometric indices, including BRI, body mass index, waist circumference, and weight, in assessing the likelihood of OAB through Receiver-operating characteristic (ROC) curves. RESULTS An independent positive correlation between OAB and BRI was identified after adjusting for potential confounders in weighted multivariate logistic models[odds ratio (OR) = 1.15, 95% confidence interval (CI), 1.12-1.17]. Weighted RCS analysis found a positive dose-response correlation between OAB and BRI. The effect size of BRI on OAB remained stable across all prespecified subgroups (all P for interactions > 0.05). In ROC analysis, BRI showed better discriminatory ability for OAB compared with other anthropometric measures for both genders (all P < 0.01). The best BRI cutoff for predicting OAB was lower for men (5.151) than for women (5.383), suggesting that men were more susceptible to changes in BRI than women. CONCLUSIONS This study demonstrated that a raised BRI is correlated with a higher likelihood of OAB. Due to the effectiveness and non-invasiveness of BRI in predicting OAB, it is expected to become the preferred method for early detection and management strategies.
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Affiliation(s)
- Yujun Zhang
- Department of Urology Surgery, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, 17 Yongwai Zheng Street, Nanchang, Jiangxi, 330006, China
- Huankui Academy, Nanchang University, Nanchang, Jiangxi, 330006, China
| | - Jingjing Song
- Department of Urology Surgery, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, 17 Yongwai Zheng Street, Nanchang, Jiangxi, 330006, China
- School of Ophthalmology, Optometry of Nanchang University, Nanchang, Jiangxi, 330006, China
| | - Benjie Li
- Department of Urology Surgery, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, 17 Yongwai Zheng Street, Nanchang, Jiangxi, 330006, China
- Queen Mary School, Nanchang University, Nanchang, Jiangxi, 330006, China
| | - Yunhao Wu
- The Second Clinical Medical College, Nanchang University, Nanchang, Jiangxi, 330006, China
| | - Shengjun Jia
- The Second Clinical Medical College, Nanchang University, Nanchang, Jiangxi, 330006, China
| | - Hongxin Shu
- Department of Neurosurgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, China
| | - Fang Liu
- Department of Health Management Medicine, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, 17 Yongwai Zheng Street, Nanchang, Jiangxi, 330006, China.
| | - Xiaorong Yang
- Department of Urology Surgery, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, 17 Yongwai Zheng Street, Nanchang, Jiangxi, 330006, China.
- Department of Urology Surgery, The First Hospital of Nanchang, Nanchang, Jiangxi, 330008, China.
- Department of Urology Surgery, The People's Hospital of Jing An County, Yichun, Jiangxi, 330600, China.
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Palleschi G, Pastore AL, Rizzello M, Cavallaro G, Silecchia G, Carbone A. Laparoscopic sleeve gastrectomy effects on overactive bladder symptoms. J Surg Res 2015; 196:307-12. [DOI: 10.1016/j.jss.2015.03.035] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 02/07/2015] [Accepted: 03/13/2015] [Indexed: 11/26/2022]
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Scozzari G, Rebecchi F, Giaccone C, Chiaro P, Mistrangelo M, Morino M. Bariatric surgery improves urinary incontinence but not anorectal function in obese women. Obes Surg 2014; 23:931-8. [PMID: 23475788 DOI: 10.1007/s11695-013-0880-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND While the association between obesity and urinary incontinence (UI) in women has been clearly documented, the relationship with anal incontinence (AI) is less well defined; moreover, while bariatric surgery has been shown to improve UI, its effect on AI is still unclear. METHODS A total of 32 obese women were studied by means of PFDI-20 and PFIQ-7 questionnaires and anorectal manometry before and after bariatric surgery and compared with 71 non-obese women. RESULTS Obese women showed worse overall questionnaire results (OR 5.18 for PFDI-20 and 2.66 for PFIQ-7). Whereas obese women showed worse results for urinary sub-items and a higher urge UI incidence (43.8 vs 18.3 %, p = 0.013), they did not show worsening in colorecto-anal symptoms. Post-operatively, median PFDI-20 total score did not change (24.2 vs 26.6, p = ns), while there was an improvement in urinary score (14.6 vs 8.3, p < 0.001); median PFIQ-7 improved (4.8 vs 0.0, p = 0.044), but while the urinary score improved (2.4 vs 0.0, p = 0.033), the colorecto-anal score did not change significantly. Although after surgery urge UI decreased from 43.8 to 15.6 % (p = 0.029), the incidence of any AI increased from 28.1 to 40.6 % (p = ns) and flatus incontinence increased from 18.8 to 37.5 % (p = ns). Anorectal manometry did not show significant changes after surgery. CONCLUSIONS Obese women had worse questionnaire results, but while showing a higher incidence of UI, they did not experience anorectal function worsening. After bariatric surgery, there was a slight improvement in PFD symptoms related to UI, but anorectal function did not change significantly and flatus incontinence increased.
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Affiliation(s)
- Gitana Scozzari
- Department of Surgical Sciences, University of Torino, C.so AM Dogliotti, 14, 10126, Turin, Italy
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