Ates Erhan, Ipekci Tumay, Akin Yigit, Kizilay Ferah, Kukul Erdal, Guntekin Erol
Department of Urology, Akdeniz University School of Medicine, Antalya, Turkey.
Department of Urology, Harran University School of Medicine, Sanliurfa, Turkey.
Neurourol Urodyn. 2016 Jan;35(1):26-8. doi: 10.1002/nau.22652. Epub 2014 Aug 11.
We investigated the effects of autonomic sympathetic dysfunction in the etiology of overactive bladder (OAB) in women, by assessing the sympathetic skin response (SSR).
In total, 40 women with OAB and 15 volunteers were enrolled. Group 1 (n = 20) consisted of patients who benefitted from oral anticholinergics, Group 2 (n = 20) consisted of patients who were refractory to oral anticholinergics, and the volunteers (n = 15) were the control group. All patients were asked to complete OAB-SF questionnaires. The absence of SSR was accepted as significant. Detailed physical examinations including neurological examinations were performed. All patients underwent SSR tests on the skin of the hands, feet, and genital area in our neurology department using electromyography, and SSR responses were recorded. Statistical significance was accepted at P < 0.05.
The mean age was 47.2 ± 12.4 years. In total, 55 women were evaluated (20 in Group 1, 20 in Group 2, and 15 in the control group). Mean OAB scores were similar between groups 1 and 2, although urgency was significantly higher in Group 2 than 1. The absence of SSR was significantly higher in Group 2 than 1 (P = 0.01). Impaired SSR was observed more commonly in Group 2 than 1. All controls had normal SSRs.
Regional dysfunction in the autonomic nervous system may be part of OAB's etiology. SSR may be a candidate test for determining early OAB, and may also be useful for predicting antimuscarinic-refractory patients.
通过评估交感神经皮肤反应（SSR），研究自主交感神经功能障碍在女性膀胱过度活动症（OAB）病因中的作用。
共纳入40例OAB女性患者和15名志愿者。第1组（n = 20）由口服抗胆碱能药物有效的患者组成，第2组（n = 20）由口服抗胆碱能药物无效的患者组成，志愿者（n = 15）为对照组。所有患者均被要求完成OAB - SF问卷。SSR缺失被视为有意义。进行了包括神经学检查在内的详细体格检查。所有患者在我们神经内科使用肌电图对手部、足部和生殖器区域的皮肤进行SSR测试，并记录SSR反应。P < 0.05被认为具有统计学意义。
平均年龄为47.2±12.4岁。总共评估了55名女性（第1组20名，第2组20名，对照组15名）。第1组和第2组的平均OAB评分相似，尽管第2组的尿急症状明显高于第1组。第2组SSR缺失明显高于第1组（P = 0.01）。第2组比第1组更常见SSR受损。所有对照组的SSR均正常。
自主神经系统的局部功能障碍可能是OAB病因的一部分。SSR可能是确定早期OAB的候选测试，也可能有助于预测抗毒蕈碱难治性患者。
