Neurophysiological Study in Overactive Bladder
Rowaida Hamdy Ali;
Abstract
Summary
T
heInternationalContinenceSociety(ICS)definesOABasthepresenceof“urinaryurgency,usuallyaccompaniedbyfrequencyandnocturia,withorwithouturgencyurinaryincontinence,intheabsenceofUTIorotherobviouspathology(Haylenetal.,2010).Urgency,thehallmarkofOAB,isdefinedasthesuddencompellingdesiretourinate,asensationthatisdifficulttodefer.Urinaryfrequencyisdefinedasvoiding8ormoretimesina24-hourperiod.Nocturiaisdefinedastheneedtowake1ormoretimespernighttovoid(AbramsP.etal.,2002).
Theoverallprevalenceofoveractivebladderis13.9%,affectingmenandwomenwithequalfrequency.Althoughitcanhappenatanyage,overactivebladderisespeciallycommoninolderadults.Overactivebladdershouldnotbeconsideredanormalpartofaging.Theprevalenceundertheageof50is<10%.Afterage60,theprevalenceincreasesto20%-30%.Itisestimatedthat60%ofpatientshavedryOAB(noleakage)while40%havewetOAB(Zornetal.,2015).
Overactivebladder(OAB)appearstobemultifactorialinbothetiologyandpathophysiology.Thecauseofdetrusoroveractivityisattributedtoalackofinhibitionofthemicturitionreflexthatisparasympatheticinnature,whilesensoryurgencyhasbeenattributedtoincreasedafferentstimuli,especiallynoxiousones(Mundy,1994).Commonconditionssuchasurinarytractinfection,kidneyandbladderstones,orbladdertumorscanallcauseoveractivityofthedetrusormuscle,resultinginoveractivebladder(Shawetal.,2011).
Somenervoussystemconditionscanincreasethesusceptibilitytodevelopoveractivebladder.Theseconditionsincludediabeticneuropathy,stroke,multiplesclerosis,spinalcordinjury,dementia,andParkinson'sdisease.Sometimesnoidentifiablecauseforoveractivebladdercanbefound.Thisistermedidiopathicoveractivebladder(Shawetal.,2011).
Overactivebladdersyndromerepresentsagreatburdenonthepatientsaffectingtheirqualitylife,itscauseisunknownincasesofidiopathicoveractivebladder,soresearcherscareaboutidentifyingtheexactetiologyofthiscondition.
Theaimofourstudywastodetectthepossibleassociationofsubtleneurogenicaffectioninidiopathicoveractivebladderandtheroleofbiofeedbackandelectricalstimulationtopelvicfloormusclesinthemanagementofoveractivebladder.
Ourstudyincluded30femalepatientscomplainingofurinaryurgencyand/orurinaryfrequencywithorwithouturinaryincontinencediagnosedasoveractivebladderwithoutanysuspectedneurologicaldisease(idiopathicoveractivebladder)and10normalfemalepersonsservingasacontrolgroup.Historytakingandclinical
T
heInternationalContinenceSociety(ICS)definesOABasthepresenceof“urinaryurgency,usuallyaccompaniedbyfrequencyandnocturia,withorwithouturgencyurinaryincontinence,intheabsenceofUTIorotherobviouspathology(Haylenetal.,2010).Urgency,thehallmarkofOAB,isdefinedasthesuddencompellingdesiretourinate,asensationthatisdifficulttodefer.Urinaryfrequencyisdefinedasvoiding8ormoretimesina24-hourperiod.Nocturiaisdefinedastheneedtowake1ormoretimespernighttovoid(AbramsP.etal.,2002).
Theoverallprevalenceofoveractivebladderis13.9%,affectingmenandwomenwithequalfrequency.Althoughitcanhappenatanyage,overactivebladderisespeciallycommoninolderadults.Overactivebladdershouldnotbeconsideredanormalpartofaging.Theprevalenceundertheageof50is<10%.Afterage60,theprevalenceincreasesto20%-30%.Itisestimatedthat60%ofpatientshavedryOAB(noleakage)while40%havewetOAB(Zornetal.,2015).
Overactivebladder(OAB)appearstobemultifactorialinbothetiologyandpathophysiology.Thecauseofdetrusoroveractivityisattributedtoalackofinhibitionofthemicturitionreflexthatisparasympatheticinnature,whilesensoryurgencyhasbeenattributedtoincreasedafferentstimuli,especiallynoxiousones(Mundy,1994).Commonconditionssuchasurinarytractinfection,kidneyandbladderstones,orbladdertumorscanallcauseoveractivityofthedetrusormuscle,resultinginoveractivebladder(Shawetal.,2011).
Somenervoussystemconditionscanincreasethesusceptibilitytodevelopoveractivebladder.Theseconditionsincludediabeticneuropathy,stroke,multiplesclerosis,spinalcordinjury,dementia,andParkinson'sdisease.Sometimesnoidentifiablecauseforoveractivebladdercanbefound.Thisistermedidiopathicoveractivebladder(Shawetal.,2011).
Overactivebladdersyndromerepresentsagreatburdenonthepatientsaffectingtheirqualitylife,itscauseisunknownincasesofidiopathicoveractivebladder,soresearcherscareaboutidentifyingtheexactetiologyofthiscondition.
Theaimofourstudywastodetectthepossibleassociationofsubtleneurogenicaffectioninidiopathicoveractivebladderandtheroleofbiofeedbackandelectricalstimulationtopelvicfloormusclesinthemanagementofoveractivebladder.
Ourstudyincluded30femalepatientscomplainingofurinaryurgencyand/orurinaryfrequencywithorwithouturinaryincontinencediagnosedasoveractivebladderwithoutanysuspectedneurologicaldisease(idiopathicoveractivebladder)and10normalfemalepersonsservingasacontrolgroup.Historytakingandclinical
Other data
| Title | Neurophysiological Study in Overactive Bladder | Other Titles | دراسةفسيولوجيةعصبيةفيمرضى فرطنشاطالمثانة | Authors | Rowaida Hamdy Ali | Issue Date | 2016 |
Attached Files
| File | Size | Format | |
|---|---|---|---|
| G13003.pdf | 407.69 kB | Adobe PDF | View/Open |
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