Observations relating to urinary sensation during detrusor overactivity.
OBJECTIVE
To describe the temporal relationship between increases in lower urinary tract (LUT) sensation and changes in detrusor and/or urethral pressures measured in real time.


METHODS
We reviewed 33 multichannel urodynamic tracings that included a continuous recording of LUT sensation and that demonstrated detrusor overactivity incontinence (DOI) or detrusor overactivity (DO). Four physicians reviewed each urodynamic tracing and reached agreement about the temporal relationship between LUT sensation and detrusor contraction.


RESULTS
Median age was 60 (36-82) years. Fourteen (42%) had urodynamic diagnoses of mixed incontinence, 18 (55%) had DOI, and 1 (3%) had DO without DOI. We reviewed 119 episodes of detrusor overactivity from the 33 recordings. We found no difference in change in sensation level when comparing DO episodes with DOI episodes or between different urodynamic diagnoses (P > 0.5). There was no dominant temporal pattern seen for the whole group (P = 0.84), that is, there was no evidence that the change in sensation level was more likely to occur before, during, or after DO/DOI episodes. When evaluating the changes in the urethral pressure, the most common pattern seen was an increase in sensation level after a fall in urethral pressure, but no dominant pattern was seen.


CONCLUSIONS
Our findings suggest that increased LUT sensation during DO/DOI is not reliably caused by measurable alterations in bladder or urethral pressure.
Lowenstein
Lior
L
Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics/Gynecology and Urology, Loyola Medical Center, Chicago, Illinois, USA.
Pham
Thythy
T
Abbasy
Shameem
S
Kenton
Kimberly
K
Brubaker
Linda
L
Mueller
Elizabeth R
ER
Shott
Susan
S
Vardi
Yoram
Y
Gruenwald
Ilan
I
FitzGerald
Mary P
MP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003950:Diagnostic Techniques, Urological / Q000295:instrumentation; D006801:Humans; D008875:Middle Aged; D009119:Muscle Contraction; D011237:Predictive Value of Tests; D011312:Pressure; D012677:Sensation; D013997:Time Factors; D014521:Urethra / Q000294:innervation / Q000503:physiopathology*; D001743:Urinary Bladder / Q000294:innervation / Q000503:physiopathology*; D053201:Urinary Bladder, Overactive / Q000175:diagnosis / Q000503:physiopathology*; D014549:Urinary Incontinence / Q000175:diagnosis / Q000503:physiopathology*; D014563:Urodynamics