F Blanc1, V Pichot, F Roche, J C Barthelemy, J Tostain. 1. Service d'Urologie-andrologie, CHU de Saint-Etìenne, Hôpital Nord, 42055 Saint-Etienne. François.Blanc@univ-st-etienne.fr
Abstract
OBJECTIVES: To compare the ANS activity, measured by heart rate variability (HRV) in various types of female urinary incontinence (UI). MATERIALS AND METHODS: 25 patients were included in this prospective study: 11 presented stress UI without sphincter incompetence, 9 presented mixed UI and 5 presented urge UI. UI without idiopathic detrusor instability (IDI) (n = 11) was compared to UI with IDI (N = 14.). No statistically significant difference was observed for mean age of the patients in the two groups. A 24-hour Holter ECG, under the conditions of the patient's everyday life, provided time and frequency indices (Fourier transform) of HRV, reflecting the sympathetic, parasympathetic and global ANS activity. RESULTS: The global ANS activity of the patients with either mixed UI, urge UI or UI with IDI, was statistically significantly lower (p < 0.05) than that of patients with stress UI. The sympathetic-vagal balance, heart rate, blood pressure, and Ditrovie score were not significantly different between the groups. CONCLUSIONS: This preliminary study shows that IDI is associated with a global reduction of ANS activity compared to that of patients without IDI. Modifications of sympathetic, parasympathetic and global ANS activity were also observed between the various types of female UI.
OBJECTIVES: To compare the ANS activity, measured by heart rate variability (HRV) in various types of female urinary incontinence (UI). MATERIALS AND METHODS: 25 patients were included in this prospective study: 11 presented stress UI without sphincter incompetence, 9 presented mixed UI and 5 presented urge UI. UI without idiopathic detrusor instability (IDI) (n = 11) was compared to UI with IDI (N = 14.). No statistically significant difference was observed for mean age of the patients in the two groups. A 24-hour Holter ECG, under the conditions of the patient's everyday life, provided time and frequency indices (Fourier transform) of HRV, reflecting the sympathetic, parasympathetic and global ANS activity. RESULTS: The global ANS activity of the patients with either mixed UI, urge UI or UI with IDI, was statistically significantly lower (p < 0.05) than that of patients with stress UI. The sympathetic-vagal balance, heart rate, blood pressure, and Ditrovie score were not significantly different between the groups. CONCLUSIONS: This preliminary study shows that IDI is associated with a global reduction of ANS activity compared to that of patients without IDI. Modifications of sympathetic, parasympathetic and global ANS activity were also observed between the various types of female UI.
Authors: Melissa R Kaufman; Laura Chang-Kit; Satish R Raj; Bonnie K Black; Douglas F Milam; W Stuart Reynolds; Italo Biaggioni; David Robertson; Roger R Dmochowski Journal: Neurourol Urodyn Date: 2016-02-09 Impact factor: 2.696