Association between overactive bladder and pelvic organ mobility as evaluated by dynamic magnetic resonance imaging

Abstract

Overactive bladder (OAB) is a prevalent condition, which negatively impacts patients’ quality of life. Pelvic organ prolapse (POP), also prevalent in women, has been recognized as an important etiology of female OAB, although the pathophysiological mechanisms remain controversial. In this study, we reviewed findings of dynamic magnetic resonance imaging (dMRI) in 118 patients with POP and investigated the association between dMRI findings, including positions and mobilities of pelvic organs as well as parameters of pelvic organ support and bladder outlet obstruction (urethral kinking), and OAB in order to elucidate the pathophysiology of OAB in patients with POP. Our results showed that compared with non-OAB patients, OAB patients had a significantly higher body mass index, more severe pelvic floor muscle impairment, and more profound supportive defects in the uterine cervix (apical compartment). On the other hand, dMRI parameters showed hardly any significant difference between patients with mild and moderate to severe OAB. These findings may imply that levator ani impairment and defective supports of the apical compartment could be associated with the presence of OAB and that the severity of OAB could be affected by factors other than those related to pelvic organ mobility and support or urethral kinking.

Association between voiding lower urinary tract symptoms and findings on dynamic magnetic resonance imaging with regard to pelvic organs and their supportive structures

“…This retrospective study represents a second analysis of a previous report focusing on the association between OAB and POM that did not investigate the association between vLUTS and POM. 8 A detailed description of the dMRI protocols and methods of evaluation of various parameters was previously reported, 8 and the latter are explained in a Figure S1. Briefly, midsagittal images were taken several times before and during abdominal straining for 10-15 s under the supervision of a specialized experienced examiner after proper prior practice.…”

“…8,25,27 Patients with vLUTS and OAB might have a more advanced lower urinary tract dysfunction, like COUB/DO-DU, based on the findings of vIPSS and dMRI. project development, manuscript writing, data analysis, interpretation of data, and manuscript editing.…”

“…2 Recently, dynamic magnetic resonance imaging (dMRI) has been used to elucidate the pathogenesis of POP as well as the pathophysiology of the lower urinary tract, sexual, and bowel dysfunction. [8][9][10][11][12] It enables clear delineation of the compartment and degree of POP during abdominal straining, pelvic organ mobility (POM), and impairment in relevant supportive structures. [8][9][10][11][12] In our previous study using dMRI and overactive bladder symptoms score (OABSS), we reported that levator ani impairment and defective supports of the apical compartment were associated with the presence of OAB.…”

“…[8][9][10][11][12] It enables clear delineation of the compartment and degree of POP during abdominal straining, pelvic organ mobility (POM), and impairment in relevant supportive structures. [8][9][10][11][12] In our previous study using dMRI and overactive bladder symptoms score (OABSS), we reported that levator ani impairment and defective supports of the apical compartment were associated with the presence of OAB. 8 However, the relationship between dMRI and vLUTS findings has not been reported.…”

“…[8][9][10][11][12] In our previous study using dMRI and overactive bladder symptoms score (OABSS), we reported that levator ani impairment and defective supports of the apical compartment were associated with the presence of OAB. 8 However, the relationship between dMRI and vLUTS findings has not been reported.…”