Aging and overactive bladder may be associated with loss of urethral sensation in women
Aging and overactive bladder may be associated with loss of urethral sensation in women
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DOI：
10.1002/nau.20444
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发表时间：
2007-01-01
影响因子：
2
通讯作者：
Brubaker, Linda
中科院分区：
文献类型：
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作者：
Kenton, Kimberly;Lowenstein, Lior;Brubaker, Linda
目的：比较特发性膀胱过度活动症患者和无症状对照组患者尿路和膀胱的电流感知阈值(CPT)。方法：在为期7天的日记中，患有每周1次急迫性尿失禁(UUI)的女性在寻求治疗UUI时，使用Neuroeter(R)CPT设备(位于马里兰州巴尔的摩的Neurotron公司)进行CPT测试。在分别对应于A-β、A-Delta和C纤维的2,000、250和5赫兹的三个频率下，在尿路和膀胱进行了测试。将UUI妇女的CPT值与一组没有下尿路症状的对照组妇女的CPT值进行比较。结果：48例无下尿路症状的对照组和13例有下尿路症状的女性进入分析。与对照组相比，尿失禁患者的年龄显著增大(平均+/-SD年龄62+/-14岁和44+/-15岁，P<；0.0005)，并且更有可能经阴道分娩(P=0.007)。尿失禁患者的2,000、250和5赫兹的尿路CPT显著高于对照组，而膀胱CPT在两组间无差异。使用Logistic回归分析，在控制年龄和产次的情况下，UUI患者的5赫兹尿路CPT仍显著高于对照组(P=0.013)。结论：老年女性的尿道感明显增强，提示下尿路感觉神经病变随年龄增长而加重，可能是随年龄增长膀胱过度活动增多的原因之一。这些数据强化了尿路在下尿路功能中的作用。
Aims: To compare current perception thresholds (CPT) in the urethra and bladder of women with idiopathic overactive bladder to asymptomatic controls. Methods: Women with >= 1 urge urinary incontinence (UUI) episode per week on 7-day diary, seeking treatment for UUI underwent CPT testing using a Neurometer (R) CPT device (Neurotron, Inc., Baltimore, MD). Testing was done in the urethra and bladder at three frequencies 2,000, 250, and 5 Hz corresponding to A-beta, A-delta, and C fibers, respectively. CPT values from the women with UUI were compared to CPT values from a group of control women without lower urinary tract symptoms. Results: Forty-eight controls without lower urinary tract symptoms and 13 women with UUI were included in the analysis. Women with UUI Were significantly older (mean +/- SD age 62 +/- 14 and 44 +/- 15, P < 0.0005) and more likely to be vaginally parous (P = 0.007) than control women. Urethral CPT at 2,000, 250, and 5 Hz were significantly higher in women with UUI than controls, while bladder CPT were not different between groups. Using logistic regression, to control for age and parity, urethral CPT at 5 Hz remained significantly higher in women with UUI than controls (P = 0.013). Conclusion: Urethral sensation is significantly higher in older women, suggesting sensory neuropathy in the lower urinary tract increases with age and may contribute to the increase in overactive bladder seen with aging. These data reinforce the role of the urethra in lower urinary tract function.