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Related Concept Videos

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Voiding Cystourethrography (VCUG) and Cystography are specialized radiographic procedures used to examine the structure and function of the bladder and urethra.Voiding Cystourethrography (VCUG)A Voiding Cystourethrogram (VCUG) is a diagnostic imaging procedure that assesses the anatomy and function of the lower urinary tract. It focuses on the bladder, bladder neck, and urethra, helping detect abnormalities such as vesicoureteral reflux (VUR)—the backward or reverse flow of urine into the...
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Uroflowmetry is a non-invasive urodynamic test designed to measure various aspects of urination, including volume, flow rate, and the time to void. This test is crucial for diagnosing and assessing conditions such as bladder outlet obstruction, bladder dysfunction, incomplete bladder emptying, incontinence, and urinary tract blockages caused by benign prostatic hyperplasia (BPH) and urethral strictures.Pre-Test Instructions:Before a uroflowmetry test, patients are typically advised to drink...
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The urinary bladder is a hollow, muscular sac that temporarily stores urine before it is expelled from the body. It can hold approximately 600 mL of urine prior to micturition. The bladder is retroperitoneal and located behind the pubic symphysis in the pelvic floor.
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Urination, or micturition involves the coordination of the bladder's detrusor muscle and two sphincters to ensure controlled bladder emptying.
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Real-Time Void Spot Assay
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Brain activation patterns of female multiple sclerosis patients with voiding dysfunction.

Rose Khavari1, Jessie Chen2, Timothy Boone1

  • 1Department of Urology, Houston Methodist Hospital, Houston, Texas.

Neurourology and Urodynamics
|February 8, 2020
PubMed
Summary

Female multiple sclerosis patients with voiding dysfunction show distinct brain activation patterns during urination compared to those without. These findings highlight differences in supraspinal control of micturition in MS-related voiding dysfunction.

Keywords:
bladderfMRIincontinencemultiple sclerosisurgency

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Area of Science:

  • Neuroscience
  • Urology
  • Radiology

Background:

  • Multiple sclerosis (MS) is a demyelinating disease affecting the central nervous system.
  • Voiding dysfunction (VD) is a common complication in female MS patients.
  • Understanding the supraspinal control of micturition in MS is crucial for managing VD.

Purpose of the Study:

  • To compare brain activation patterns during micturition initiation in female MS patients with and without VD.
  • To identify differences in supraspinal correlates of voiding control between these groups.

Main Methods:

  • Functional magnetic resonance imaging (fMRI) and simultaneous urodynamic testing were used.
  • Twenty-eight female MS patients were divided into two groups: without VD (n=14) and with VD (n=14).
  • Brain activation maps were analyzed, focusing on a priori regions of interest involved in micturition.

Main Results:

  • Patients with VD exhibited significantly lower activation in most brain regions associated with voiding initiation compared to those without VD.
  • Negative blood-oxygen level-dependent (BOLD) signals were observed in the pontine micturition center and other key areas in the VD group, contrasting with positive signals in the non-VD group.
  • Brain activation patterns in MS patients without VD resembled those of healthy controls.

Conclusions:

  • Distinct supraspinal activation patterns differentiate female MS patients with and without voiding dysfunction.
  • These findings suggest altered central nervous system control of micturition in MS patients experiencing VD.