Measuring the sensations of urge and bladder filling during cystometry in urge incontinence and the effects of neuromodulation

  title={Measuring the sensations of urge and bladder filling during cystometry in urge incontinence and the effects of neuromodulation},
  author={Sarah Oliver and Clare J. Fowler and Anthony Mundy and Michael Duncan Craggs},
  journal={Neurourology and Urodynamics},
As urge and urgency contribute greatly to a patient's symptoms, it follows that sensory evaluation combined with noninvasive neuromodulation during urodynamics may provide new criteria for improving patient selection for an implantable stimulator. The purpose of this research was to develop and validate an objective measure of bladder sensations during filling cystometry and then to apply this technique to evaluate the effects of neuromodulation on the sensations of urge measured in this way. 

Objective measurement of bladder sensation: use of a new patient‐activated device and response to neuromodulation

It was shown that the sensation of urgency can be suppressed by neuromodulation in most patients tested; this suppression occurs with improvements in bladder capacity and voided volumes, and it was suggested that urodynamics with concurrent sensory evaluation may offer a more useful assessment tool for selecting those patients for therapies such as neurommodulation who present predominantly with the symptom of urgency.

The role of electrical stimulation techniques in the management of the male patient with urgency incontinence

Both sacral neuromodulation and percutaneous tibial nerve stimulation prove to be viable, durable options for treating patients with refractory urge incontinence and alternative modes of stimulation are also beginning to show promise.


The diagnosis of overactive bladder (OAB) is based on the key symptoms of urgency and urinary frequency, which could be related to abnormal bladder contraction or afferent nerve activity. The

Measuring urgency in clinical practice

Measurement of urgency in clinical practice and indeed the optimal treatment strategy has yet to come of age because no single measure currently captures its multidimensional nature.

The Sensation Meter: An Unprompted Method to Characterize Patient-Reported Bladder Sensation in Real-Time

A novel Sensation Meter is developed, a patient interface implemented on a touchscreen device that continuously records the patient’s real-time, unprompted sensation of bladder fullness.

Neuromodulation techniques: A comparison of available and new therapies

Neuromodulation has become ever more common in the fields of urology and voiding dysfunction but more information is needed to broaden the applicability of neuromodulations to larger numbers of patients and conditions.

Urgency assessment in the evaluation of overactive bladder (OAB)

Important issues relevant to the clinical assessment and measurement scales commonly used to evaluate and measure urinary urgency are outlined, which will have important implications toward further understanding and advancing the field of overactive bladder.

Validation of a real-time urodynamic measure of urinary sensation.

Can a faked cystometry deceive patients in their perception of filling sensations? A study on the reliability of spontaneously reported cystometric filling sensations in patients with non‐neurogenic lower urinary tract dysfunction

To evaluate the reliability of spontaneously reported bladder sensations during real and faked cystometry in patients with non‐neurogenic lower urinary tract dysfunction, Cystometry is used as a surrogate for pelvic organ prolapse testing.



Bladder inhibition by penile electrical stimulation.

Transcutaneous electrical stimulation was applied to the penis in 22 patients complaining of frequency, urgency and/or urge incontinence, causing decreased bladder spasticity and/ or increased cystometric capacity in 10 of 22 patients.

Does electrostimulation cure urinary incontinence?

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Long–Term Effectiveness of Sacral Nerve Stimulation for Refractory Urge Incontinence

Sacral nerve stimulation is an effective treatment for refractory urge incontinent with sustained long–term benefit through an average of 30.8 months.

The urodynamic evaluation of neuromodulation in patients with voiding dysfunction

The ideal candidates for neuromodulation are those patients with a spastic pelvic floor syndrome or with a hypocontractile detrusor, in combination with sphincter instability, and impaired spHincter relaxation.

New concepts in relation to urge and detrusor activity

Investigations of micromotion characteristics of bladder wall strips and pressure wave phenomena in total bladders in vitro and in vivo indicate thatmicromotion phenomena occur in the bladder wall, which could explain the weak relation between urge and pressure.

One hundred unstable bladders.

Investigating the correlation between presenting symptoms and cystometric data in patients with urodynamically proven detrusor instability found no significant correlations between the symptoms of urinary frequency and urgency and any of the cystometrograms.

Effects of external and direct pudendal nerve maximal electrical stimulation in the treatment of the uninhibited overactive bladder.

MES seems to be an effective first-line treatment for the uninhibited overactive bladder, with a significant increase in functional bladder capacity and 11 reported a 30% decrease in the frequency of micturition.