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Neurophysiologic study in idiopathic overactive bladder
Author(s) -
Ali Rowaida H.,
Gadallah Naglaa A.,
El Zohiery Abeer K.,
Elwy Mohamed,
Serag Ihab
Publication year - 2019
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.23834
Subject(s) - medicine , pudendal nerve , reflex , external anal sphincter , overactive bladder , somatosensory evoked potential , urethral sphincter , electromyography , urinary urgency , pathogenesis , pelvic floor , somatosensory system , urology , anesthesia , urinary incontinence , surgery , physical medicine and rehabilitation , anal canal , pathology , rectum , alternative medicine , psychiatry
Aim Idiopathic overactive bladder (OAB) is a prevalent, mystifying disorder with a questionable neurogenic background. We aimed to investigate the possible subtle neuropathic affection underlying its pathogenesis. Methods A cross‐sectional cut off study was carried out on a series of 38 females with idiopathic OAB and 22 healthy matched female volunteers. The following was performed: symptom score questionnaire, determination of pudendal nerve terminal motor latency (PNTML), sacral reflexes’ latencies, pudendal somatosensory evoked potentials, and needle electromyography of the external anal and urethral sphincters. Results A highly significant prolongation of PNTMLs and sacral reflexes latencies among the patients group was detected ( P ≥ 0.001). Pudendal somatosensory evoked potentials showed non‐ significance among the two studied groups ( P ≥ 0.05). External anal sphincter neuropathic affection was detected in 27 patients (71%) and external urethral sphincter neuropathic affection was detected in 30 patients (78.9%). The clitoral anal reflex showed the highest sensitivity and specificity among the neurophysiologic tests used in assessing the neuropathic affection (86.7 and 83%, respectively), followed by PNTML (83.3 and 80%, respectively). Conclusion Pudendal neuropathy is the dominating possible attributing factor in the pathogenesis underlying idiopathic OAB. An integrated clinical, urodynamic, and electro‐physiological assessment is recommended for evaluation of any overactive bladder patients.