title: Sensory function assessment of the human male lower urinary tract using current perception thresholds.
abstract: To evaluate the feasibility and reliability of current perception threshold (CPT) measurement for sensory assessment of distinct locations in the male lower urinary tract (LUT).
  
  
  
  Twelve male subjects (>18 years) without LUT symptoms or medical comorbidities were eligible. CPTs were determined twice (interval: 7-20 days) at the bladder dome, trigone and the proximal, membranous, and distal urethra. Square wave electrical stimulation of 3 Hz/0.2 ms and 0.5 Hz/1 ms was applied using a transurethral 8F catheter placed under fluoroscopic control. Bladder volume was kept constant (60 mL) using a second 10F catheter. Repetitive measurements and reliability were assessed by analysis of variance (ANOVA) and intraclass correlation coefficient (ICC).
  
  
  
  The ANOVA revealed significant main effects for stimulation site (P = 0.008) and type of stimulation (P < 0.001) with lower CPTs for 0.5 Hz/1 ms compared to 3 Hz/0.2 ms. There was no significant effect for visit number (P = 0.061). CPTs were higher for bladder dome than for proximal (0.5 Hz/1 ms: P = 0.022; 3 Hz/0.2 ms: P = 0.022) and distal urethra (0.5 Hz/1 ms: P = 0.026; 3 Hz/0.2 ms: P = 0.030). Reliability of CPT measurements was excellent to good (ICC = 0.67-0.96) except for the bladder dome (5 Hz/1 ms: ICC = 0.45; 3 Hz/0.2 ms: ICC = 0.20) and distal urethra (3 Hz/0.2 ms: ICC = 0.57).
  
  
  
  CPTs can be reliably detected at different LUT locations. However, alert and compliant subjects are essential. CPTs of LUT may become a complementary assessment method providing information on responsiveness and sensitivity of afferent LUT nerves. This is especially relevant for urethral afferents, which are not covered by standard urodynamic investigations. Neurourol. Urodynam. 36:469-473, 2017. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Neuro-Urology, Spinal Cord Injury Center and Research, Balgrist University Hospital, University of Zürich, Zürich, Switzerland.
authors.forename: Stephanie C
authors.initials: SC
authors.lastname: Knüpfer
authors.affiliation: Department of Neuro-Urology, Spinal Cord Injury Center and Research, Balgrist University Hospital, University of Zürich, Zürich, Switzerland.
authors.forename: Martina D
authors.initials: MD
authors.lastname: Liechti
authors.affiliation: Department of Neuro-Urology, Spinal Cord Injury Center and Research, Balgrist University Hospital, University of Zürich, Zürich, Switzerland.
authors.forename: Flavia
authors.initials: F
authors.lastname: Gregorini
authors.affiliation: Department of Urology, Antwerp University Hospital and Faculty of Medicine, University of Antwerp, Antwerp, Belgium.
authors.forename: Stefan
authors.initials: S
authors.lastname: De Wachter
authors.affiliation: Department of Neuro-Urology, Spinal Cord Injury Center and Research, Balgrist University Hospital, University of Zürich, Zürich, Switzerland.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Kessler
authors.affiliation: Department of Neuro-Urology, Spinal Cord Injury Center and Research, Balgrist University Hospital, University of Zürich, Zürich, Switzerland.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Mehnert
mesh_terms: D000328:Adult; D004558:Electric Stimulation; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D012677:Sensation / Q000502:physiology*; D011984:Sensory Receptor Cells / Q000502:physiology*; D012684:Sensory Thresholds / Q000502:physiology*; D014521:Urethra / Q000294:innervation / Q000502:physiology; D001743:Urinary Bladder / Q000502:physiology*; D014563:Urodynamics / Q000502:physiology*; D055815:Young Adult
keywords: afferent nerves; current perception threshold; lower urinary tract; sensory pathways; urethra