Aging and overactive bladder may be associated with loss of urethral sensation in women.
OBJECTIVE
To compare current perception thresholds (CPT) in the urethra and bladder of women with idiopathic overactive bladder to asymptomatic controls.


METHODS
Women with > or =1 urge urinary incontinence (UUI) episode per week on 7-day diary, seeking treatment for UUI underwent CPT testing using a Neurometer(R) CPT device (Neurotron, Inc., Baltimore, MD). Testing was done in the urethra and bladder at three frequencies 2,000, 250, and 5 Hz corresponding to A-beta, A-delta, and C fibers, respectively. CPT values from the women with UUI were compared to CPT values from a group of control women without lower urinary tract symptoms.


RESULTS
Forty-eight controls without lower urinary tract symptoms and 13 women with UUI were included in the analysis. Women with UUI were significantly older (mean +/- SD age 62 +/- 14 and 44 +/- 15, P < 0.0005) and more likely to be vaginally parous (P = 0.007) than control women. Urethral CPT at 2,000, 250, and 5 Hz were significantly higher in women with UUI than controls, while bladder CPT were not different between groups. Using logistic regression, to control for age and parity, urethral CPT at 5 Hz remained significantly higher in women with UUI than controls (P = 0.013).


CONCLUSIONS
Urethral sensation is significantly higher in older women, suggesting sensory neuropathy in the lower urinary tract increases with age and may contribute to the increase in overactive bladder seen with aging. These data reinforce the role of the urethra in lower urinary tract function.
Kenton
Kimberly
K
Division of Female Pelvic Medicine and Reconstructive Surgery, Departments of Urology and Obstetrics and Gynecology, Loyola University Medical Center, Maywood, IL 60153, USA. kkenton@lumc.edu
Lowenstein
Lior
L
Simmons
Jennifer
J
Brubaker
Linda
L
D000328:Adult; D000368:Aged; D000375:Aging / Q000502:physiology*; D016022:Case-Control Studies; D002404:Catheterization; D004558:Electric Stimulation; D004864:Equipment and Supplies; D005260:Female; D006801:Humans; D008875:Middle Aged; D009475:Neurons, Afferent / Q000502:physiology*; D014521:Urethra / Q000294:innervation* / Q000503:physiopathology; D001743:Urinary Bladder / Q000294:innervation / Q000503:physiopathology; D053201:Urinary Bladder, Overactive / Q000503:physiopathology*; D053202:Urinary Incontinence, Urge / Q000503:physiopathology