Neurogenic Urethra: Clinical Relevance of Isolated Neuropathic
Dysfunction of the Urethra, and the Denervation Supersensitivity of
the Urethra Revisited

Koyanagi, Tomohiko; Morita, Hajime; Taniguchi, Kouichi; Kubota, Masatoshi; Shinno, Yuki; Takamatsu, Tsuneo

doi:10.1159/000473401

Cited by 7 publications

(3 citation statements)

References 22 publications

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“…Urethral pressure was measured before and after infusion of norepinephrine with a rate of 0.1 mg/kg/min for 5 minutes. A urethral pressure rise greater than 10 mm H 2 O is considered high [Koyanagi et al, 1988]. A bethanechol test was performed in six patients.…”

Section: Methodsmentioning

confidence: 99%

Uroneurological assessment of spina bifida cystica and occulta

Sakakibara

Hattori

Uchiyama

et al. 2003

Neurourology and Urodynamics

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Spina bifida cystica and occulta present with a wide spectrum of urodynamic abnormalities including upper and lower motoneuron types of bladder and urethral dysfunction. Careful uroneurological assessment and spinal magnetic resonance imaging are important for diagnosing young adult patients with spina bifida occulta because they may present with urinary symptoms as the sole initial complaint and have no other obvious neurological abnormalities.

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Section: Methodsmentioning

confidence: 99%

Uroneurological assessment of spina bifida cystica and occulta

Sakakibara

Hattori

Uchiyama

et al. 2003

Neurourology and Urodynamics

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“…Impaired urethral relaxation would be a major cause of high R after RH. In infrasacral NB, the postganglionic adrenergic system, which is free from regulation by the parasympathetic post-ganglionic neurons due to parasympathetic denervation, is responsible for the urethral denervation supersensitivity to noradrenalin [20]. Damage to the inferior hypogastric plexus may also result in increased resistance at the bladder neck, although the precise mechanisms are not clear [3].…”

Section: Discussionmentioning

confidence: 99%

Impact of Adjuvant Radiotherapy and Reversibility of Neurogenic Bladder on Bladder Storage Function and Impact of Urethral Resistance on Bladder Emptying Function after Radical Hysterectomy

Sekido¹,

Yoshino²,

Takaoka³

et al. 2017

OJU

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Purpose: To clarify which patients need careful neurourological management after abdominal radical hysterectomy (RH) by investigating the effects of adjuvant radiotherapy and reversibility of neurogenic bladder (NB) on the storage function as well as the effects of urethral resistance on the emptying function. Methods: Data from sixty-two patients referred to our NB clinic after RH were retrospectively reviewed. Findings of urodynamic studies performed at 3 (UDS-1) and 12 (UDS-2) months after treatment were compared, and logistic analysis was used to calculate the odds ratio (OR) of the effects of radiotherapy and irreversible NB on decreased bladder capacity and decreased compliance. Irreversible NB was defined as the need for clean intermittent catheterization at the last follow-up. Results: At the median follow-up period of 41 months, 60% of the patients continued to require clean intermittent catheterization. Of patients with irreversible NB and radiotherapy, 80% had decreased bladder capacity and decreased compliance at UDS-2. For decreased bladder capacity and decreased compliance, ORs of adjuvant radiotherapy at UDS-2 were 38.42 (p < 0.001) and 7.46 (p = 0.001), respectively, while ORs of irreversible NB were 1.64 (p = 0.527) and 3.42 (p = 0.062), respectively. Detrusor contraction could be demonstrated in only 15% and 45% at UDS-1 and UDS-2, respectively. However, regardless of

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“…A V ds test might be insensitive in patients with diabetic cystopathy and in only severe cases a V ds test might be positive. Interestingly, Morita et al [1989] reported that in diabetic patients there was a greater chance of detecting denervation supersensitivity of the urethra to an alpha-sympathetic agonist [Koyanagi, 1978;Koyanagi et al, 1988] than of the bladder [Morita et al, 1989]. This implied that the isolated neurogenic dysfunction of the urethra, as evidenced by denervation supersensitivity of the urethra in the absence of V ds , is a real possibility in voiding dysfunction of diabetic patients [Morita et al, 1989].…”

Section: Discussionmentioning

confidence: 99%

Vesicourethral function in diabetic patients: Association of abnormal nerve conduction velocity with vesicourethral dysfunction

Mitsui

Κakizaki

Kobayashi

et al. 1999

Neurourol. Urodynam.

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This study was undertaken to examine diabetic vesicourethral dysfunction in association with nerve conduction velocity. Uroflowmetry, water cystometry, International Prostate Symptom Score (IPSS), and nerve conduction velocity were analyzed in 29 diabetic patients (21 men and eight women; a mean age, 58.0 years). Nerve conduction velocity was measured for sensory nerve conduction velocity (SCV) of the sural nerve and motor nerve conduction velocity (MCV) of the peroneal nerve. Normal voiding was defined as continuous flow at the normal flow rate and residual urine <50 mL. Results of uroflowmetry and cystometry were compared with those of nerve conduction velocity. Eleven of 29 patients (38%) had voiding dysfunction. A vesical denervation supersensitivity test was negative in all patients. The mean IPSS was not significant different between patients with or without voiding dysfunction. Incidence of bladder volume at first desire to void >300 mL and maximum bladder capacity >500 mL were significantly higher in patients with abnormal SCV than those with normal SCV (P < 0.03 and 0.001, respectively). Eleven of 16 patients with abnormal MCV showed voiding dysfunction, whereas all patients with normal MCV showed normal voiding (P < 0.001). These results suggest that lower urinary tract symptoms alone cannot predict diabetic vesicourethral dysfunction and that diabetic vesicourethral dysfunction is highly correlated with abnormal nerve conduction velocity. Neurourol. Urodynam. 18:639–645, 1999. © 1999 Wiley‐Liss, Inc.

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Neurogenic Urethra: Clinical Relevance of Isolated Neuropathic Dysfunction of the Urethra, and the Denervation Supersensitivity of the Urethra Revisited

Cited by 7 publications

References 22 publications

Uroneurological assessment of spina bifida cystica and occulta

Uroneurological assessment of spina bifida cystica and occulta

Impact of Adjuvant Radiotherapy and Reversibility of Neurogenic Bladder on Bladder Storage Function and Impact of Urethral Resistance on Bladder Emptying Function after Radical Hysterectomy

Vesicourethral function in diabetic patients: Association of abnormal nerve conduction velocity with vesicourethral dysfunction

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