Journal article
Expanded Physiological Testing of the Lower Urinary Tract In Asymptomatic Women and Those With Urgency Urinary Incontinence: Findings From the LURN‐Organ Study
Neurourology and urodynamics, Vol.44(5), pp.987-996
06/2025
DOI: 10.1002/nau.70038
PMCID: PMC12414437
PMID: 40159923
Abstract
Purpose
To investigate sensory and motor function of the bladder and urethra in women with and without urgency urinary incontinence (UUI).
Materials and Methods
Treatment-seeking women with UUI and healthy, asymptomatic, nontreatment seeking controls enrolled in the Symptoms of Lower Urinary Tract Dysfunction Research Network Organ-Based study (LURN-Organ) and underwent a single session of physiological testing. Testing included rapid-fill cystometry before and after lidocaine administration, urethral pressure profiles, pelvic floor contraction (Kegel) testing, and tuning fork sensation testing at the urethral meatus.
Results
Data were collected from 31 asymptomatic controls and 56 women with UUI. Women with UUI were more likely to demonstrate detrusor overactivity (DO) (32% vs. 10% in controls, p = 0.019). In addition, women with UUI on average generated 25% lower active urethral closure pressures during maximal contraction (p = 0.0016) and reported sensations at lower volumes during cystometry (34% lower for first desire to void, p = 0.028; 34% lower for strong desire to void, p = 0.0017; and 32% lower for maximum cystometric capacity, p = 0.0047). Women with UUI demonstrated diminished urethral sensation on the tuning fork test (median of 7 vs. 8 in controls) though the difference was not significant (p = 0.054). Considerable overlap in all findings occurred between cases and controls in each parameter. While individual component comparisons revealed some differences, additional multivariable analysis demonstrated prominently the physiological heterogeneity of women with UUI.
Conclusions
Women with UUI demonstrated varying amounts of bladder sensory dysfunction, urethral motor dysfunction and bladder motor dysfunction. Considering the function of lower urinary tract components in combination may reveal UUI phenotypes, highlighting the need to study UUI from a multifactorial perspective.
Details
- Title: Subtitle
- Expanded Physiological Testing of the Lower Urinary Tract In Asymptomatic Women and Those With Urgency Urinary Incontinence: Findings From the LURN‐Organ Study
- Creators
- James A. Hokanson - Marquette UniversityJohn O. L. DeLancey - University of MichiganAnna C. Kirby - University of WashingtonBrenda Gillespie - Arbor Research Collaborative for HealthH. Henry Lai - Washington University in St. Louis School of MedicineKarl J. Kreder - Department of Urology University of Iowa Iowa City Iowa USAC. Emi Bretschneider - Northwestern UniversityNick Slavik - Marquette UniversityCalvin Andrews - Arbor Research Collaborative for HealthVictor Andreev - Arbor Research Collaborative for HealthLinda Black - Washington University in St. Louis School of MedicineSarah Richardson - University of MichiganKimberly Kenton - University of ChicagoZiya Kirkali - National Institute of Diabetes and Digestive and Kidney DiseasesClaire C. Yang - University of WashingtonSymptoms of Lower Urinary Tract Dysfunction Research Network (LURN) Study Group
- Resource Type
- Journal article
- Publication Details
- Neurourology and urodynamics, Vol.44(5), pp.987-996
- DOI
- 10.1002/nau.70038
- PMID
- 40159923
- PMCID
- PMC12414437
- NLM abbreviation
- Neurourol Urodyn
- ISSN
- 0733-2467
- eISSN
- 1520-6777
- Publisher
- Wiley; HOBOKEN
- Grant note
- This study is supported by the National Institute of Diabetes Digestive Kidney Diseases through cooperative agreements (grants DK097780, DK097772, DK097779, DK099932, DK100011, DK100017, DK099879). Dr. Hokanson was also funded in part by a K01 (DK12186: DK097780, DK097772, DK097779, DK099932, DK100011, DK100017, DK099879, DK121866 National Institute of Diabetes & Digestive & Kidney Diseases: UL1TR001422 National Institutes of Health's National Center for Advancing Translational Sciences
This is publication number 46 of the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN). This study is supported by the National Institute of Diabetes & Digestive & Kidney Diseases through cooperative agreements (grants DK097780, DK097772, DK097779, DK099932, DK100011, DK100017, DK099879). Dr. Hokanson was also funded in part by a K01 (DK121866). Research reported in this publication was supported at Northwestern University, in part, by the National Institutes of Health's National Center for Advancing Translational Sciences, Grant Number UL1TR001422. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
- Language
- English
- Electronic publication date
- 03/31/2025
- Date published
- 06/2025
- Academic Unit
- Obstetrics and Gynecology; Urology
- Record Identifier
- 9984805010302771
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