Nagle Anna S, Speich John E, De Wachter Stefan G, Ghamarian Peter P, Le David M, Colhoun Andrew F, Ratz Paul H, Barbee Robert W, Klausner Adam P
Department of Mechanical & Nuclear Engineering, Virginia Commonwealth University School of Engineering, Richmond, Virginia.
Department of Urology, University Hospital Antwerpen, Edegem, University of Antwerpen, Wilrijk, Belgium.
Neurourol Urodyn. 2017 Jun;36(5):1417-1426. doi: 10.1002/nau.23137. Epub 2016 Sep 21.
The purpose of this investigation was to develop a non-invasive, objective, and unprompted method to characterize real-time bladder sensation.
Volunteers with and without overactive bladder (OAB) were prospectively enrolled in a preliminary accelerated hydration study. Participants drank 2L Gatorade-G2® and recorded real-time sensation (0-100% scale) and standardized verbal sensory thresholds using a novel, touch-screen "sensation meter." 3D bladder ultrasound images were recorded throughout fillings for a subset of participants. Sensation data were recorded for two consecutive complete fill-void cycles.
Data from 14 normal and 12 OAB participants were obtained (ICIq-OAB-5a = 0 vs. ≥3). Filling duration decreased in fill2 compared to fill1, but volume did not significantly change. In normals, adjacent verbal sensory thresholds (within fill) showed no overlap, and identical thresholds (between fill) were similar, demonstrating effective differentiation between degrees of %bladder capacity. In OAB, within-fill overlaps and between-fill differences were identified. Real-time %capacity-sensation curves left shifted from fill1 to fill2 in normals, consistent with expected viscoelastic behavior, but unexpectedly right shifted in OAB. 3D ultrasound volume data showed that fill rates started slowly and ramped up with variable end points.
This study establishes a non-invasive means to evaluate real-time bladder sensation using a two-fill accelerated hydration protocol and a sensation meter. Verbal thresholds were inconsistent in OAB, and the right shift in OAB %capacity-sensation curve suggests potential biomechanical and/or sensitization changes. This methodology could be used to gain valuable information on different forms of OAB in a completely non-invasive way.
本研究旨在开发一种非侵入性、客观且无需提示的方法来描述实时膀胱感觉。
前瞻性招募有和没有膀胱过度活动症(OAB)的志愿者参与一项初步的加速水化研究。参与者饮用2L佳得乐-G2®,并使用一种新型触摸屏“感觉计”记录实时感觉(0-100%量表)和标准化言语感觉阈值。在部分参与者的整个充盈过程中记录三维膀胱超声图像。连续记录两个完整的充盈-排空周期的感觉数据。
获得了14名正常参与者和12名OAB参与者的数据(国际尿失禁咨询委员会尿失禁问卷简表-5a=0对≥3)。与充盈1相比,充盈2的充盈持续时间缩短,但容量无显著变化。在正常参与者中,相邻的言语感觉阈值(充盈内)无重叠,相同的阈值(充盈间)相似,表明膀胱容量百分比程度之间有有效区分。在OAB患者中,发现了充盈内重叠和充盈间差异。正常参与者中,实时容量百分比-感觉曲线从充盈1到充盈2左移,符合预期的粘弹性行为,但OAB患者中意外右移。三维超声体积数据显示充盈速率开始缓慢,终点各不相同。
本研究建立了一种使用两阶段加速水化方案和感觉计评估实时膀胱感觉的非侵入性方法。OAB患者的言语阈值不一致,OAB容量百分比-感觉曲线右移表明可能存在生物力学和/或致敏变化。这种方法可用于以完全非侵入性的方式获取关于不同形式OAB的有价值信息。