Sensory function assessment of the human male lower urinary tract using current perception thresholds

Area of Science:

• Urology
• Neuroscience
• Sensory Physiology

Background:

• Standard urodynamic investigations do not fully assess afferent nerve sensitivity in the lower urinary tract (LUT).
• Current perception threshold (CPT) measurement offers a potential method for evaluating sensory function in the LUT.

Purpose of the Study:

• To determine the feasibility and reliability of CPT measurements for sensory assessment at various locations within the male LUT.
• To explore the potential of CPT as a complementary diagnostic tool for LUT afferent nerve function.

Main Methods:

• Twelve healthy adult males underwent repeated CPT measurements at the bladder dome, trigone, and proximal, membranous, and distal urethra.
• Electrical stimulation was applied transurethrally using specific frequencies and pulse durations, with bladder volume maintained consistently.
• Analysis of variance (ANOVA) and intraclass correlation coefficient (ICC) were used to assess measurement reliability.

Main Results:

• CPT varied significantly based on stimulation site and type, with lower thresholds observed for 0.5 Hz/1 ms stimulation compared to 3 Hz/0.2 ms.
• CPTs were higher at the bladder dome than in the proximal and distal urethra.
• Reliability was generally excellent to good (ICC 0.67-0.96), with exceptions noted for the bladder dome and distal urethra under specific stimulation conditions.

Conclusions:

• CPT measurements are feasible and reliable for assessing sensation in most male LUT locations.
• Alert and compliant participants are crucial for accurate CPT assessment.
• CPT measurement can serve as a valuable complementary method to assess afferent LUT nerve sensitivity, particularly for urethral afferents.