Visceral and cutaneous sensory testing in patients with painful bladder syndrome
Visceral and cutaneous sensory testing in patients with painful bladder syndrome
复制标题
DOI：
10.1002/nau.20178
复制
发表时间：
2005-01-01
影响因子：
2
通讯作者：
Senka, J
中科院分区：
文献类型：
--
作者：
FitzGerald, MP;Koch, D;Senka, J
目的：我们的目的是确定膀胱疼痛综合征（PBS）受试者是否表现出内脏疼痛综合征的特征：内脏痛觉过敏，膀胱感觉的参照部位扩大，重复充盈引起的膀胱疼痛增加，相关皮区中皮肤刺激的阈值降低，相关皮区中对重复皮肤刺激的异常反应，并开发易于应用的PBS疼痛评估和管理措施。方法：我们招募了PBS受试者和对照组受试者，无膀胱疼痛，压力性尿失禁（SUI）或无尿失禁。受试者接受了三次膀胱充盈，最多300 ml，并绘制了膀胱充盈/不适图，对任何疼痛进行评级。在C5、T6、T10、T12、S3皮区测试2000 Hz、250 Hz、5 Hz的皮肤电流感觉阈值（CPT）。然后对T12、S3皮区进行重复阈上刺激，每次15个刺激，间隔2秒。结果如下：PBS受试者表现出对膀胱充盈的痛觉过敏，并且倾向于在耻骨上和外阴/尿道部位感觉到膀胱不适。在任何刺激频率下，任何皮区的CPT均无差异。PBS和SI受试者倾向于不习惯于重复刺激，而无症状对照倾向于习惯于重复刺激。结论：PBS受试者表现出膀胱痛觉过敏，并可能在耻骨上以外的部位感觉到膀胱不适。膀胱测压期间膀胱不适和感觉的评级、映射有效地区分PBS受试者和对照。
Aims: Our aims were to determine whether subjects with painful bladder syndrome (PBS) demonstrate characteristics of visceral pain syndromes: visceral hyperalgesia, expanded loci of referral of bladder sensation, increased bladder pain with repetitive filling, lower thresholds to cutaneous stimulation in relevant dermatomes, abnormal response to repetitive cutaneous stimulation in relevant dermatomes, and also to develop easily applied measures for PBS pain evaluation and management. Methods: We recruited PBS subjects and control subjects with no bladder pain and with either stress urinary incontinence (SUI) or no incontinence. Subjects underwent three bladder fills up to maximum 300 ml and mapped bladder fullness/discomfort, rating any pain present. Cutaneous current perception thresholds (CPTs) were tested at 2000 Hz, 250 Hz, 5 Hz at C5, T6, T10, T12, S3 dermatomes. Repetitive supra-threshold stimulation in trains of 15 stimuli 2 see apart were then administered to T12, S3 dermatomes. Results: PBS subjects demonstrated hyperalgesia to bladder filling and tended to sense bladder discomfort at both suprapubic and vulvar/urethral sites. There v as no difference in CPTs at any dermatome at any stimulating frequency. PBS and SI subjects tended not to habituate to repetitive stimuli, while asymptomatic controls tended to habituate to repetitive stimulation. Conclusions: PBS subjects demonstrate bladder hyperalgesia and may sense bladder discomfort at sites other than suprapubic. Rating of bladder discomfort and sensory, mapping during cystometry usefully, distinguishes between PBS subjects and controls.