Aging and overactive bladder may be associated with loss of urethral sensation in women

Abstract

Urethral sensation is significantly higher in older women, suggesting sensory neuropathy in the lower urinary tract increases with age and may contribute to the increase in overactive bladder seen with aging. These data reinforce the role of the urethra in lower urinary tract function.

Aging and the underactive detrusor: A failure of activity or activation?

“…47,48 The impact of aging on bladder and urethral sensations has been clinically assessed with current perception testing. Current perception thresholds (CPT) at frequencies corresponding to urethral c-fiber afferents were increased with age; bladder thresholds differences did not achieve significance in this study, 49 although large data variations, unequal distributions, and technical considerations suggest the latter may be a type II error. Functional MRI in asymptomatic patients demonstrates age-related diminished responses to bladder filling in the insula, an area of the brain responsible for mapping visceral sensations.…”

Obstructive voiding symptoms are not predictive of elevated postvoid residual urine volumes

“…The lack of association between obstructive voiding symptoms and urinary retention may be attributed to the fact that both prolapse and detrusor hypocontractility are chronic changes that happen gradually and are likely associated with neuropathic changes. In our previous work, we found that urethral sensation is significantly higher in older women, suggesting that sensory neuropathy in the lower urinary tract increases with age [12]. This neurologically mediated lack of lower urinary tract sensation may allow the bladder to "adjust," so women are not clinically aware or bothered by the increased bladder volumes.…”

The role of the neurometer CPT/C in sacral neuromodulation

“…[15] Measurement of CPT in the genital area has been reported previously for the transvaginal [16] and transurethral regions. [14,17] To our knowledge, this is the first study which evaluated the bladder/urethral sensation using a transdermal approach targeted at S2-4 distribution (Figure 1). …”