Department of Urogynaecology, St. George Hospital, University of New South Wales, Kogarah, New South Wales, Australia.
J Urol. 2010 Mar;183(3):1082-6. doi: 10.1016/j.juro.2009.11.028. Epub 2010 Jan 21.
Adenosine triphosphate released from urothelium during stretch stimulates afferent nerves and conveys information on bladder fullness. We measured adenosine triphosphate released during cystometric bladder filling in women with idiopathic detrusor overactivity and stress incontinence (controls), and assessed whether the level of released adenosine triphosphate is related to cystometric parameters.
Routine cystometry was done in 51 controls and 48 women with detrusor overactivity who were 28 to 87 years old. Voided urodynamic fluid was collected and stored at -30 C. Adenosine triphosphate was measured by a bioluminescence assay.
Adenosine triphosphate levels were similar in voided urodynamic fluid of controls and patients with detrusor overactivity (p = 0.79). A significant inverse correlation was seen between adenosine triphosphate and maximal cystometric capacity in controls (p = 0.013), and between voided volume and adenosine triphosphate in controls (p = 0.015) and detrusor overactivity cases (p = 0.019). A significant correlation between first desire to void and adenosine triphosphate was also noted in detrusor overactivity cases (p = 0.033) but not in controls (p = 0.58). No correlation was seen between adenosine triphosphate and detrusor pressure during filling or voiding.
Adenosine triphosphate measurement in voided urodynamic fluid is a novel approach to understanding signals that may contribute to the urgency sensation (a sudden compelling desire to pass urine). The inverse correlation between adenosine triphosphate in voided urodynamic fluid and first desire to void suggests that adenosine triphosphate has a role in modulating the early filling sensation in patients with detrusor overactivity.
在拉伸过程中，从尿路上皮释放的三磷酸腺苷刺激传入神经，并传递关于膀胱充盈的信息。我们测量了特发性逼尿肌过度活动和压力性尿失禁（对照组）患者在膀胱测压充盈过程中释放的三磷酸腺苷，并评估了释放的三磷酸腺苷水平是否与膀胱测压参数有关。
对 51 名对照组和 48 名逼尿肌过度活动的患者进行常规膀胱测压，年龄 28 至 87 岁。收集并储存排空尿动力学尿液-30°C。通过生物发光测定法测量三磷酸腺苷。
对照组和逼尿肌过度活动患者的排空尿动力学尿液中的三磷酸腺苷水平相似（p=0.79）。对照组中三磷酸腺苷与最大膀胱容量呈显著负相关（p=0.013），对照组和逼尿肌过度活动患者中排空量与三磷酸腺苷呈显著负相关（p=0.015 和 p=0.019）。在逼尿肌过度活动患者中，首次排尿欲望与三磷酸腺苷之间也存在显著相关性（p=0.033），但在对照组中没有相关性（p=0.58）。在充盈或排空过程中，三磷酸腺苷与逼尿肌压力之间没有相关性。
在排空尿动力学尿液中测量三磷酸腺苷是一种了解可能导致尿急感（一种突然强烈的排尿欲望）信号的新方法。排空尿动力学尿液中的三磷酸腺苷与首次排尿欲望呈负相关，表明三磷酸腺苷在调节逼尿肌过度活动患者的早期充盈感方面起作用。
