title: Bladder sensation in peripheral nerve lesions.
abstract: OBJECTIVE
  To present bladder sensory data of three common peripheral nerve lesions (e.g., distal, intermediate/focal, and proximal).
  
  
  METHODS
  We measured first sensation (FS) and bladder capacity (BC) (not exceeding 600 ml) in 71 patients with peripheral nerve lesions: 35 diabetic neuropathy (D group), 6 post-pelvic surgery (S), and 27 cauda equina syndrome due to lumbar spondylosis (L). We excluded those with detrusor overactivity or low compliance that might affect bladder sensation.
  
  
  RESULTS
  The mean FS was 301.7 ml (D), 271.3 ml (S), and 189.4 ml (L), with the largest being in the D group (P < 0.05); the mean BC was 495.2, 475.4, and 391.4 ml, with the largest being in the D group (P < 0.05); who commonly had less frequent toileting. The mean post-void residual volume was 106.5, 29.0, and 42.0 ml; the values tended to increase along with BC. In the D group, the mean FS in patients with skin hypoalgesia as detected by pin prick and in those without it was 407.8 and 210.0 ml. The percentage of patients with FS < 100 ml was 5.7%, 0%, and 7.4%, respectively, who commonly had urinary urgency and frequency.
  
  
  CONCLUSIONS
  Bladder sensation is affected in diabetic neuropathy more severely than in intermediate/proximal lesions, together with somatic sensory disturbance. Bladder sensory disturbance leads to less frequent toileting, resulting in bladder over-distension and large post-void residuals. A small proportion of patients with peripheral nerve lesions develop urinary urgency, presumably reflecting irritation of the afferent nerve fibers or the urothelium.
authors.affiliation: Central Laboratory Unit, Chiba University Hospital, Chiba, Japan.
authors.forename: Chiharu
authors.initials: C
authors.lastname: Yamaguchi
authors.forename: Ryuji
authors.initials: R
authors.lastname: Sakakibara
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Uchiyama
authors.forename: Zhi
authors.initials: Z
authors.lastname: Liu
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Takashi
authors.initials: T
authors.lastname: Ito
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Awa
authors.forename: Kaori
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Mika
authors.initials: M
authors.lastname: Kinou
authors.forename: Tomonori
authors.initials: T
authors.lastname: Yamanishi
authors.forename: Fumio
authors.initials: F
authors.lastname: Nomura
authors.forename: Takamichi
authors.initials: T
authors.lastname: Hattori
mesh_terms: D000368:Aged; D001259:Ataxia / Q000503:physiopathology; D016208:Databases, Factual; D003929:Diabetic Neuropathies / Q000503:physiopathology; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000209:etiology / Q000503:physiopathology*; D011128:Polyradiculopathy / Q000503:physiopathology; D011183:Postoperative Complications / Q000503:physiopathology; D012189:Retrospective Studies; D012678:Sensation Disorders / Q000209:etiology / Q000503:physiopathology*; D013128:Spinal Osteophytosis / Q000503:physiopathology; D011795:Surveys and Questionnaires; D001743:Urinary Bladder / Q000294:innervation / Q000503:physiopathology; D001745:Urinary Bladder Diseases / Q000150:complications / Q000503:physiopathology*