Involuntary Detrusor Contraction Is a Frequent Finding in Patients with Recurrent Urinary Tract Infections

Rodrigues, Pedro Luiz Coelho; Hering, F.; Campagnari, João Carlos

doi:10.1159/000356063

Cited by 13 publications

(12 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As we have previously highlighted, this suggests possible relevance of central sensitization even to ostensibly nonpainful conditions, such as OAB . At present, we can only speculate as to any source of persistent C‐fiber input that might first initiate central sensitization in OAB, but investigators have suggested roles for urinary tract infection, urinary retention, and other precipitating events, which could represent the requisite high‐threshold stimulation for the “silent” bladder C‐fiber activation needed for central sensitization induction …”

Section: Discussionmentioning

confidence: 79%

Temporal summation to thermal stimuli is elevated in women with overactive bladder syndrome

Reynolds

Brown

Danford

et al. 2016

Neurourology and Urodynamics

View full text Add to dashboard Cite

Introduction This study sought to provide a preliminary assessment of whether spinally-mediated afferent hyperactivity (i.e. central sensitization) might contribute to manifestations of Overactive Bladder Syndrome (OAB) in women as indexed by elevated temporal summation of evoked heat pain stimuli. Methods We recruited 20 adult women with OAB who were planning to undergo interventional therapy for OAB with either onabotulinumtoxinA injection or sacral neuromodulation and 23 healthy controls without OAB symptoms to undergo quantitative sensory testing with cutaneous thermal pain temporal summation. The primary study outcome was the degree of temporal summation, as reflected in the magnitude of positive slope of the line fitted to the series of 10 stimuli at the 49°C target temperatures. Linear regression and analysis of covariance were utilized to compare the degree of temporal summation between study groups. Results The standardized slope of temporal summation trials for women with OAB was significantly higher than for Controls (beta = 3.43, 95% confidence interval = 0.6 – 6.2, p = .017). The adjusted means ± SE of the standardized temporal summation slopes for the full OAB and Control groups were 3.0 ± .5 (95% confidence interval = 2.0, 4.1) and 1.7 ± .5 (95% confidence interval = .7, 2.7), respectively. Conclusion In this preliminary study, we demonstrated that women with OAB refractory to primary and secondary therapies exhibited greater thermal cutaneous temporal summation than women without OAB symptoms. This suggests that central sensitization, indexed by temporal summation, may be an underlying factor contributing to OAB in some women.

show abstract

Section: Discussionmentioning

confidence: 79%

Temporal summation to thermal stimuli is elevated in women with overactive bladder syndrome

Reynolds

Brown

Danford

et al. 2016

Neurourology and Urodynamics

View full text Add to dashboard Cite

show abstract

“…The characteristics of excluded studies: 11 studies were excluded after the review of the full manuscript. Data was not extractable in 2 studies [20,21]. One study was focusing at the incidence of recurrent UTIs and did not report on investigation findings [2].…”

Section: Characteristics Of Studiesmentioning

confidence: 99%

Recurrent Urinary Tract Infections in Women: What Is the Evidence for Investigating with Flexible Cystoscopy, Imaging and Urodynamics?

Santoni

Skews

et al. 2018

Urol Int

View full text Add to dashboard Cite

Background/Aims/Objectives: Women with recurrent urinary tract infections (UTIs) are commonly referred to urology outpatient clinics. However, there is no clear consensus in existing guidelines as to if, or how, these should be investigated. The primary outcome was to evaluate all available literature to determine the percentage of abnormal findings in non-pregnant women with recurrent simple UTIs. Secondary outcomes were to determine the percentage that were serious, consequential or incidental findings. Methods: A full literature search was performed of the following databases: MEDLINE; Pubmed; Cochrane Central Register of Controlled Trials-CENTRAL; and ClinicalTrials.gov. Two assessors reviewed the articles independently. Any discrepancy was discussed and an agreement reached. Results: The literature search yielded 662 titles; 652 were excluded on initial review. A further 13 studies were gathered from references of yielded papers. After full review, 12 were included for analysis. These showed that < 1.5% of women investigated for recurrent simple UTIs with imaging or flexible cystoscopy had life-threatening pathology, but up to 67% had abnormal urodynamics. Conclusions: Women presenting with simple recurrent UTIs should have a flow rate and post-void residual measured. Cystoscopy is not warranted and imaging is unlikely to be of value in the absence of symptoms of upper tract disease or gynaecological problems.

show abstract

“…In normal physiological conditions, bladder distention activates the non-nociceptive A␦ afferents that trigger a spinobulbospinal reflex (10), while nociceptive C-fiber afferents are silent (14). In pathological conditions such as spinal cord injury (7,9) or bladder infection/irritation that induce bladder overactivity (21), the nociceptive C-fiber afferents are also activated which triggers a spinal micturition reflex (14,27).…”

mentioning

confidence: 99%

Role of spinal metabotropic glutamate receptor 5 in pudendal inhibition of the nociceptive bladder reflex in cats

Reese

Rogers

Xiao

et al. 2015

American Journal of Physiology-Renal Physiology

View full text Add to dashboard Cite

This study examined the role of spinal metabotropic glutamate receptor 5 (mGluR5) in the nociceptive C-fiber afferent-mediated spinal bladder reflex and in the inhibtion of this reflex by pudendal nerve stimulation (PNS). In α-chloralose-anesthetized cats after spinal cord transection at the T9/T10 level, intravesical infusion of 0.25% acetic acid irritated the bladder, activated nociceptive C-fiber afferents, and induced spinal reflex bladder contractions of low amplitude (<50 cmH2O) and short duration (<20 s) at a smaller bladder capacity ∼80% of saline control capacity. PNS significantly (P < 0.01) increased bladder capacity from 85.5 ± 10.1 to 137.3 ± 14.1 or 148.2 ± 11.2% at 2T or 4T stimulation, respectively, where T is the threshold intensity for PNS to induce anal twitch. MTEP {3-[(2-methyl-4-thiazolyl)ethynyl]pyridine; 3 mg/kg iv, a selective mGluR5 antagonist} completely removed the PNS inhibition and significantly (P < 0.05) increased bladder capacity from 71.8 ± 9.9 to 94.0 ± 13.9% of saline control, but it did not change the bladder contraction amplitude. After propranolol (3 mg/kg iv, a β1/β2-adrenergic receptor antagonist) treatment, PNS inhibition remained but MTEP significantly (P < 0.05) reduced the bladder contraction amplitude from 18.6 ± 2.1 to 6.6 ± 1.2 cmH2O and eliminated PNS inhibition. At the end of experiments, hexamethonium (10 mg/kg iv, a ganglionic blocker) significantly (P < 0.05) reduced the bladder contraction amplitude from 20.9 ± 3.2 to 8.1 ± 1.5 cmH2O on average demonstrating that spinal reflexes were responsible for a major component of the contractions. This study shows that spinal mGluR5 plays an important role in the nociceptive C-fiber afferent-mediated spinal bladder reflex and in pudendal inhibition of this spinal reflex.

show abstract

Involuntary Detrusor Contraction Is a Frequent Finding in Patients with Recurrent Urinary Tract Infections

Cited by 13 publications

References 30 publications

Temporal summation to thermal stimuli is elevated in women with overactive bladder syndrome

Temporal summation to thermal stimuli is elevated in women with overactive bladder syndrome

Recurrent Urinary Tract Infections in Women: What Is the Evidence for Investigating with Flexible Cystoscopy, Imaging and Urodynamics?

Role of spinal metabotropic glutamate receptor 5 in pudendal inhibition of the nociceptive bladder reflex in cats

Contact Info

Product

Resources

About