Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei, Taiwan.
Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan.
Sci Rep. 2020 May 5;10(1):7549. doi: 10.1038/s41598-020-64532-0.
The pathophysiology of female overactive bleeder syndrome (OAB) remains undetermined. Our aim is to elucidate the role of vacularization and overall perfusion of the bladder wall in women with OAB. Between 2010 and 2016, women with OAB and the asymptomatic controls were enrolled. Women with OAB were treated with tolterodine. Women with OAB (n = 40) had higher vascularization index (0.40 ± 0.57 versus 0.17 ± 0.22, p = 0.003), vascularization-flow index (0.15 ± 0.28 versus 0.05 ± 0.08, p = 0.003) and thicker trigone (0.56 ± 0.13 cm versus 0.47 ± 0.11 cm, p = 0.004), compared with the controls (n = 34). The following optimum cut-off values to predict OAB were determined: (1) vascularization index (%) ≥ 0.16, (2) vascularization-flow index ≥ 0.032, and (3) trigone bladder wall thickness ≥ 0.47 cm with an area under the curve of 0.71, 0.71 and 0.70, respectively. Correlation analysis showed that a significant correlation between urgency and vascularization index/vascularization-flow index (Spearman's rho = 0.34 and 0.35, respectively, all p < 0.01). However, after 12 weeks of tolterodine treatment, the vascularization index, flow index and vascularization-flow index did not differ between baseline and after treatment. In conclusion, women with OAB have higher vascularization and overall perfusion of the bladder wall, compared women without OAB. However, vascularization and overall perfusion did not change after antimuscarinic treatment.
女性过度活动性膀胱综合征（OAB）的病理生理学仍未确定。我们的目的是阐明血管化和膀胱壁整体灌注在 OAB 女性中的作用。2010 年至 2016 年间，招募了 OAB 女性和无症状对照者。OAB 女性接受托特罗定治疗。OAB 女性（n=40）的血管化指数（0.40±0.57 比 0.17±0.22，p=0.003）、血管化-血流指数（0.15±0.28 比 0.05±0.08，p=0.003）和三角区厚度（0.56±0.13cm 比 0.47±0.11cm，p=0.004）均高于对照组（n=34）。确定了预测 OAB 的最佳截断值：（1）血管化指数（%）≥0.16，（2）血管化-血流指数≥0.032，（3）三角区膀胱壁厚度≥0.47cm，曲线下面积分别为 0.71、0.71 和 0.70。相关性分析显示，急迫性与血管化指数/血管化-血流指数之间存在显著相关性（Spearman's rho 分别为 0.34 和 0.35，均 p<0.01）。然而，托特罗定治疗 12 周后，基线和治疗后血管化指数、血流指数和血管化-血流指数无差异。总之，与无 OAB 女性相比，OAB 女性的膀胱壁血管化和整体灌注更高。然而，抗毒蕈碱治疗后血管化和整体灌注没有改变。
