Department of Urology, The Catholic University of Korea School of Medicine, Seoul, Korea.
Int Neurourol J. 2010 Dec;14(4):232-7. doi: 10.5213/inj.2010.14.4.232. Epub 2010 Dec 31.
Stress urinary incontinence (SUI) and urge urinary incontinence (UUI) have different mechanisms of action. We believe that alteration of autonomic nervous system (ANS) activity may contribute to UUI because the lower urinary tract is regulated through the sympathetic and parasympathetic nervous systems. Heart rate variability (HRV) allows measurement of autonomic nervous function, therefore we measured and compared HRV parameters in women with urinary incontinence.
From March 2008 to March 2010, we evaluated all patients who visited 2 university hospitals for treatment of urinary incontinence. Theywere performed 3-day voiding diary, urodynamic study, physical examination and routine laboratory examination. We excluded subjects who had diabetes, cardiovascular problems, or other condition that affect ANS. Patients with mixed urinary incontinence (MUI) were also excluded. Finally 47 women with SUI (group 1) and 29 women with UUI (group 2) were enrolled according to their symptoms and voiding diary. We compared their HRV parameters. And excluding 11 patients who had detrusor underactivity, we divided them again into group A, 53 women without detrusor overactivity (DO) and group B, 12 women with DO. We compared HRV parameters between DO and non-DO group.
Older women had a higher incidence of UUI and DO. In HRV parameters, only the ratio of low frequency (LF) and high frequency (HF) was significantly higher in group 2 than group 1 (3.5±3.6 vs. 1.6±1.1, P<0.05). Also group A had higher mean LF/HF ratio than group B (4.3±3.8 vs. 1.9±1.9, P<0.05).
Increased LF/HF values indicate relative sympathetic hyperactivity over parasympathetic activity. Changes in ANS activity could indicate the presence of UUI and potentially DO.
压力性尿失禁（SUI）和急迫性尿失禁（UUI）的发病机制不同。我们认为自主神经系统（ANS）活动的改变可能与 UUI 有关，因为下尿路通过交感和副交感神经系统进行调节。心率变异性（HRV）可用于测量自主神经功能，因此我们测量并比较了患有尿失禁的女性的 HRV 参数。
2008 年 3 月至 2010 年 3 月，我们评估了所有因治疗尿失禁而到 2 所大学医院就诊的患者。他们进行了 3 天的排尿日记、尿动力学研究、体格检查和常规实验室检查。我们排除了患有糖尿病、心血管问题或其他影响 ANS 的疾病的患者。也排除了混合性尿失禁（MUI）患者。最终，根据症状和排尿日记，根据 47 名 SUI 患者（第 1 组）和 29 名 UUI 患者（第 2 组）纳入研究。我们比较了他们的 HRV 参数。并排除 11 名逼尿肌活动低下的患者，将他们再次分为无逼尿肌过度活动（DO）的 53 名女性的组 A 和 12 名有 DO 的女性的组 B。我们比较了 DO 和非 DO 组之间的 HRV 参数。
年龄较大的女性 UUI 和 DO 的发生率更高。在 HRV 参数中，只有第 2 组的低频（LF）与高频（HF）的比值明显高于第 1 组（3.5±3.6 比 1.6±1.1，P<0.05）。组 A 的平均 LF/HF 比值也高于组 B（4.3±3.8 比 1.9±1.9，P<0.05）。
LF/HF 值的增加表明相对的交感神经活性高于副交感神经活性。ANS 活动的改变可能表明存在 UUI 并可能存在 DO。
