University Hospital of Limerick , Dooradoyle , Limerick , Ireland.
University College Hospital Galway , Galway City , Galway , Ireland.
J Urol. 2019 Aug;202(2):326-332. doi: 10.1097/JU.0000000000000199. Epub 2019 Jul 8.
Many self-help guides advise patients that spreading fluid intake throughout the day can reduce overactive bladder symptoms. However, although animal studies suggest a link between a faster filling rate and increased afferent nerve firing, to our knowledge the relationship between the filling rate and bladder sensation has not been examined in humans. The aim of this study was to investigate the effect of bladder volume and the bladder filling rate on the bladder sensation and voiding patterns of patients with overactive bladder.
A control group of 40 female volunteers were recruited by open advertisement. A further 24 female patients with overactive bladder were recruited from the urology outpatient department. Each participant completed the UDI-6 (Urinary Distress Inventory, Short Form), the IIQ-7 (Incontinence Impact Questionnaire, Short Form) and a 3-day sensation related bladder diary.
The proportion of urgent voids in the control group increased with increasing voided volume and bladder filling rates (each p ≤0.001). The proportion of urgent voids in patients with overactive bladder also increased with increasing voided volume and bladder filling rates (p = 0.004 and 0.013, respectively). On regression analysis the rate of bladder filling was an independent predictor of urgent voids in patients with overactive bladder but not in the control group. Patients with overactive bladder were less tolerant of higher bladder filling rates, and experienced most grades of bladder sensation at lower voided volumes and filling rates than the control group.
The bladder filling rate appears to influence the intervoiding interval and the sensation associated with each void in patients with overactive bladder. Advising patients to lower the bladder filling rate should help reduce urinary frequency, urgency and urge incontinence.
许多自助指南建议患者全天分散饮水可以减轻膀胱过度活动症的症状。然而，尽管动物研究表明充盈率加快与传入神经放电增加之间存在关联，但据我们所知，充盈率与膀胱感觉之间的关系尚未在人体中进行研究。本研究旨在探讨膀胱容量和充盈率对膀胱过度活动症患者的膀胱感觉和排尿模式的影响。
通过公开广告招募了 40 名女性志愿者作为对照组。另外，从泌尿科门诊招募了 24 名女性膀胱过度活动症患者。每位参与者均完成了 UDI-6（尿失禁困扰问卷，简表）、IIQ-7（尿失禁影响问卷，简表）和 3 天感觉相关的膀胱日记。
对照组中紧急排尿的比例随排尿量和膀胱充盈率的增加而增加（p≤0.001）。膀胱过度活动症患者中紧急排尿的比例也随排尿量和膀胱充盈率的增加而增加（分别为 p=0.004 和 0.013）。回归分析显示，膀胱充盈率是膀胱过度活动症患者紧急排尿的独立预测因素，但对对照组没有影响。膀胱过度活动症患者对较高的膀胱充盈率的耐受性较差，而且与对照组相比，在较低的排尿量和充盈率时，经历了更多级别的膀胱感觉。
膀胱充盈率似乎会影响膀胱过度活动症患者的两次排尿之间的间隔和每次排尿时的感觉。建议患者降低膀胱充盈率可能有助于减少尿频、尿急和急迫性尿失禁。
