title: Does adenosine triphosphate released into voided urodynamic fluid contribute to urgency signaling in women with bladder dysfunction?
abstract: OBJECTIVE
  Adenosine triphosphate released from urothelium during stretch stimulates afferent nerves and conveys information on bladder fullness. We measured adenosine triphosphate released during cystometric bladder filling in women with idiopathic detrusor overactivity and stress incontinence (controls), and assessed whether the level of released adenosine triphosphate is related to cystometric parameters.
  
  
  METHODS
  Routine cystometry was done in 51 controls and 48 women with detrusor overactivity who were 28 to 87 years old. Voided urodynamic fluid was collected and stored at -30 C. Adenosine triphosphate was measured by a bioluminescence assay.
  
  
  RESULTS
  Adenosine triphosphate levels were similar in voided urodynamic fluid of controls and patients with detrusor overactivity (p = 0.79). A significant inverse correlation was seen between adenosine triphosphate and maximal cystometric capacity in controls (p = 0.013), and between voided volume and adenosine triphosphate in controls (p = 0.015) and detrusor overactivity cases (p = 0.019). A significant correlation between first desire to void and adenosine triphosphate was also noted in detrusor overactivity cases (p = 0.033) but not in controls (p = 0.58). No correlation was seen between adenosine triphosphate and detrusor pressure during filling or voiding.
  
  
  CONCLUSIONS
  Adenosine triphosphate measurement in voided urodynamic fluid is a novel approach to understanding signals that may contribute to the urgency sensation (a sudden compelling desire to pass urine). The inverse correlation between adenosine triphosphate in voided urodynamic fluid and first desire to void suggests that adenosine triphosphate has a role in modulating the early filling sensation in patients with detrusor overactivity.
authors.affiliation: Department of Urogynaecology, St. George Hospital, University of New South Wales, Kogarah, New South Wales, Australia.
authors.forename: Ying
authors.initials: Y
authors.lastname: Cheng
authors.forename: Kylie J
authors.initials: KJ
authors.lastname: Mansfield
authors.forename: Wendy
authors.initials: W
authors.lastname: Allen
authors.forename: Colin A
authors.initials: CA
authors.lastname: Walsh
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Burcher
authors.forename: Kate H
authors.initials: KH
authors.lastname: Moore
mesh_terms: D000255:Adenosine Triphosphate / Q000502:physiology* / Q000652:urine*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D053201:Urinary Bladder, Overactive / Q000503:physiopathology* / Q000652:urine*; D014550:Urinary Incontinence, Stress / Q000503:physiopathology* / Q000652:urine*; D014563:Urodynamics
chemical_list: D000255:Adenosine Triphosphate