Is overactive bladder a nervous or bladder disorder? Autonomic imaging in patients with overactive bladder via dynamic pupillometry.
OBJECTIVE
To evaluate the changes in dynamic pupillometry in patients with idiopathic overactive bladder (OAB).


METHODS
The study included 40 female patients with idiopathic OAB and 40 healthy female volunteers as a control group. Demographic and clinical data were recorded. Dynamic pupillometric parameters were measured with a commercially available unit (MonPack One, Metrovision, France) at baseline and on the 30th day of treatment with an antimuscarinic treatment (drug-agent) (solifenacin 5 mg daily). Initial, minimum, maximum and mean pupil diameters, the latency and duration of contraction and dilatation of the pupil, the amplitude of contraction and dilatation velocity were automatically measured and compared between the groups.


RESULTS
There were no significant differences between two groups with respect to age and body mass index (p = 0.288, 0.755, respectively). The measurements of initial, minimum and mean pupil diameters were significantly lower in patients with OAB compared to healthy controls (p = 0.007, 0.002, 0.001, respectively). OAB patients had significantly longer latency of pupil dilatation, latency of pupil contraction and shorter duration of pupil contraction than control group (p = 0.028, 0.029, 0.021, respectively). After the antimuscarinic treatment, latency of pupil contraction, latency of pupil dilatation and duration of pupil contraction shortened significantly (all p < 0.001). Pupil dilatation velocity increased significantly during the treatment (p < 0.001).


CONCLUSIONS
The dynamic pupillometric findings in this study imply impaired autonomic dysfunction, mostly the increased parasympathetic action, in OAB patients and the modulatory effects of antimuscarinic treatment.
Department of Urology, Etimesgut Military Hospital, Ankara, Turkey. yasinaydogmus@hotmail.com.
Yasin
http://orcid.org/0000-0003-4037-6611
Y
Aydogmus
Department of Ophthalmology, Etimesgut Military Hospital, Ankara, Turkey.
Salih
S
Uzun
Department of Ophthalmology, GATA Medical School, Ankara, Turkey.
Fatih C
FC
Gundogan
Department of Neurology, GATA Medical School, Ankara, Turkey.
Umit Hidir
UH
Ulas
Department of Urology, Etimesgut Military Hospital, Ankara, Turkey.
Turgay
T
Ebiloglu
Department of Pharmacology, Yildirim Beyazit University Medical School, Ankara, Turkey.
Mustafa Tugrul
MT
Goktas
D000328:Adult; D001342:Autonomic Nervous System Diseases / Q000503:physiopathology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000627:therapeutic use; D010275:Parasympathetic Nervous System / Q000503:physiopathology*; D011680:Pupil / Q000502:physiology*; D011681:Pupil Disorders / Q000150:complications / Q000503:physiopathology*; D000069464:Solifenacin Succinate / Q000627:therapeutic use; D013997:Time Factors; D001743:Urinary Bladder / Q000294:innervation / Q000503:physiopathology; D053201:Urinary Bladder, Overactive / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D055815:Young Adult
D018727:Muscarinic Antagonists; D000069464:Solifenacin Succinate
Autonomic nervous system; Overactive bladder; Parasympathetic nervous system; Pupillometry; Sympathetic nervous system