[Detrusor activity and motor neurons firing during micturition: analysis by means of modeling of urodynamic tracings].
BACKGROUND
To use a computer assisted analysis of urodynamic tracings (VBN method) in order to propose a quantitative description of the relationship between detrusor activity and firing of efferent motor neurons.


METHODS
Modeling of the nervous control implies three definitions of the detrusor excitation: (1) related to the contractile force (EF), (2) related to the calcium turnover (ECa) and (3) ratio of firing motor neurons (rr). The associate variables have been computed from each uroflow recording of healthy volunteers (male and female) and patients (107 men with lower urinary tract symptoms due to benign prostatic enlargement and 138 women with stress urinary incontinence).


RESULTS
A "standard excitation" governs all the voidings of healthy volunteers. For 47% of male patients and 75% of female patients, a non-standard excitation is observed: beginning as the standard excitation, then sudden break at a time tc (9.7 +/- 2.5 s for male and 4.0 +/- 2.7 s for women). rr has an all-or-none value in case of standard excitation and exhibits a two steps behavior with after tc: = 0.53 +/- 0.21 for men and 0.41 +/- 0.18 for women (non-significant despite the difference in the origin of disease).


CONCLUSIONS
VBN computer analysis of urodynamic tracings allows to propose a description of the detrusor nervous control: (1) an on-off nervous order rules the "standard" detrusor activity, and (2) a feedback, which probably starts at the urethral level, acts to switch an on-off reduction of the detrusor activity in the other cases.
Valentini
F-A
FA
Laboratoire d'urodynamique et de neurophysiologie vésicale, UPRES EA 2393, université Pierre-et-Marie-Curie (Paris-VI), hôpital Jean-Rostand, 39-41, rue Jean-Le-Galleu, 94200 Ivry-sur-Seine, France. francoise.valentini@jrs.ap-hop-paris.fr
Nelson
P-P
PP
Besson
G-R
GR
D000328:Adult; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D009046:Motor Neurons / Q000502:physiology*; D018482:Muscle, Skeletal / Q000502:physiology*; D011470:Prostatic Hyperplasia / Q000150:complications; D001743:Urinary Bladder / Q000294:innervation*; D014549:Urinary Incontinence / Q000503:physiopathology; D014554:Urination / Q000502:physiology*; D014563:Urodynamics / Q000502:physiology*