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Neurophysiologic study in idiopathic overactive bladder.

Rowaida H Ali1, Naglaa A Gadallah1, Abeer K El Zohiery1

  • 1Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Ain Shams University, Cairo, Egypt.

Neurourology and Urodynamics
|October 13, 2018
PubMed
Summary

Idiopathic overactive bladder (OAB) may stem from pudendal neuropathy. Neurophysiological tests reveal significant nerve affection in OAB patients, suggesting this as a key cause.

Keywords:
detrusor overactivitypelvic floor electromyographypudendal nerve terminal motor latencysacral reflexes

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Area of Science:

  • Neuroscience
  • Urology
  • Neurology

Background:

  • Idiopathic overactive bladder (OAB) is a common condition with an unclear cause.
  • A potential neurogenic origin for OAB has been suspected but not fully elucidated.

Purpose of the Study:

  • To investigate subtle neuropathic changes in patients with idiopathic OAB.
  • To identify the role of pudendal nerve dysfunction in OAB pathogenesis.

Main Methods:

  • A cross-sectional study involving 38 females with idiopathic OAB and 22 healthy controls.
  • Utilized symptom scoring, pudendal nerve terminal motor latency (PNTML), sacral reflexes, evoked potentials, and sphincter electromyography.

Main Results:

  • Significantly prolonged PNTML and sacral reflexes were observed in OAB patients (P<0.001).
  • Neuropathic affection was detected in 71% of external anal sphincters and 78.9% of external urethral sphincters.
  • Clitoral anal reflex and PNTML demonstrated high sensitivity and specificity for detecting neuropathy.

Conclusions:

  • Pudendal neuropathy appears to be a primary factor in the pathogenesis of idiopathic OAB.
  • Recommends integrated clinical, urodynamic, and electrophysiological assessments for OAB patients.