Clavica Francesco, Choudhary Mahipal, van Asselt Els, van Mastrigt Ron
Department of Urology, Sector FURORE, Erasmus MC, Rotterdam, The Netherlands.
Bristol Urological Institute, Southmead Hospital, Bristol, United Kingdom.
Neurourol Urodyn. 2015 Nov;34(8):794-9. doi: 10.1002/nau.22664. Epub 2014 Sep 8.
To test the hypothesis that voiding in anesthetized rats is preceded by recurrent changes in the pattern of bladder pressure. To explore the use of frequency analysis as an analytical tool for automatically detecting these changes and to provide quantitative data on bladder pre-voiding activity.
We developed an algorithm, based on frequency analysis, to study bladder pressure during the filling phase in anesthetized rats. Two applications of the algorithm were tested: (i) as a predictor of a voiding contraction with alarms generated which would make conditional nerve stimulation to prevent incontinence possible; and (ii) as a new index to quantify rapid pressure transients in normal and overactive detrusor conditions (i.e., induced by acetic acid instillation into the bladder).
The results show that a very high percentage (∼90%) of the alarms was generated by the algorithm within 100 sec before voiding. The index of rapid transients and the bladder volume before voiding were respectively ∼13% less and ∼42% less in acetic acid.
We have shown that a simple algorithm, based on frequency analysis of bladder pressure, can be used to predict voiding and to provide quantitative data on non-voiding bladder activity and its changes due to pathology. Although the results refer to anesthetized rats, they are promising and warrant further urodynamic investigation to identify if similar patterns occur in non-anesthetized rats and in humans.
验证麻醉大鼠排尿前膀胱压力模式会反复变化这一假说。探索将频率分析用作自动检测这些变化的分析工具,并提供膀胱排尿前活动的定量数据。
我们开发了一种基于频率分析的算法,用于研究麻醉大鼠膀胱充盈期的压力。对该算法的两种应用进行了测试:(i)作为排尿收缩的预测指标,并生成警报,以便进行有条件的神经刺激以预防尿失禁;(ii)作为一种新指标,用于量化正常和逼尿肌过度活动状态(即通过向膀胱内注入乙酸诱导)下的快速压力瞬变。
结果表明,该算法在排尿前100秒内产生了非常高比例(约90%)的警报。在乙酸处理组中,快速瞬变指数和排尿前膀胱容量分别减少了约13%和约42%。
我们已经表明,一种基于膀胱压力频率分析的简单算法可用于预测排尿,并提供关于非排尿膀胱活动及其病理变化的定量数据。尽管结果是针对麻醉大鼠的,但它们很有前景,值得进一步进行尿动力学研究,以确定在未麻醉大鼠和人类中是否会出现类似模式。