Department of Urology, Toho University Graduate School of Medicine, 5-21-16 Omorinishi, Ota City, Tokyo, 143-8540, Japan.
Department of Urology, Toho University Ohashi Medical Center, 2-22-36 Ohashi, Meguro City, Tokyo, 153-8515, Japan.
Sci Rep. 2021 Jul 2;11(1):13726. doi: 10.1038/s41598-021-93143-6.
Overactive bladder (OAB) is a prevalent condition, which negatively impacts patients' quality of life. Pelvic organ prolapse (POP), also prevalent in women, has been recognized as an important etiology of female OAB, although the pathophysiological mechanisms remain controversial. In this study, we reviewed findings of dynamic magnetic resonance imaging (dMRI) in 118 patients with POP and investigated the association between dMRI findings, including positions and mobilities of pelvic organs as well as parameters of pelvic organ support and bladder outlet obstruction (urethral kinking), and OAB in order to elucidate the pathophysiology of OAB in patients with POP. Our results showed that compared with non-OAB patients, OAB patients had a significantly higher body mass index, more severe pelvic floor muscle impairment, and more profound supportive defects in the uterine cervix (apical compartment). On the other hand, dMRI parameters showed hardly any significant difference between patients with mild and moderate to severe OAB. These findings may imply that levator ani impairment and defective supports of the apical compartment could be associated with the presence of OAB and that the severity of OAB could be affected by factors other than those related to pelvic organ mobility and support or urethral kinking.
膀胱过度活动症（OAB）是一种常见病症，会对患者的生活质量产生负面影响。盆腔器官脱垂（POP）在女性中也很常见，已被认为是女性 OAB 的重要病因，但病理生理机制仍存在争议。在这项研究中，我们回顾了 118 例 POP 患者的动态磁共振成像（dMRI）结果，并研究了 dMRI 结果（包括盆腔器官的位置和移动度以及盆腔器官支持和膀胱出口梗阻（尿道扭曲）的参数）与 OAB 之间的关系，以阐明 POP 患者 OAB 的病理生理学。我们的结果表明，与非 OAB 患者相比，OAB 患者的体重指数显著更高，盆底肌肉损伤更严重，子宫颈（顶部隔室）的支撑缺陷更明显。另一方面，dMRI 参数在轻度和中重度 OAB 患者之间几乎没有显著差异。这些发现可能意味着肛提肌损伤和顶部隔室的支撑缺陷可能与 OAB 的存在有关，而 OAB 的严重程度可能受到与盆腔器官移动度和支撑或尿道扭曲无关的因素的影响。
