Rose Khavari1, Timothy B Boone1. 1. Department of Urology, Houston Methodist Hospital, 6560 Fannin St. Suite 2100, Houston, TX, 77030.
Abstract
PURPOSE OF REVIEW: Voiding dysfunction (VD) is morbid, costly, and leads to urinary tract infections, stones, sepsis, and permanent renal failure. Evaluation and diagnosis of VD in non-obstructed patients can be challenging. Potential diagnostic and therapeutic options beyond the bladder, such as brain centers involved in voiding have been proposed as promising targets. This review focuses on current and future applications of functional neuroimaging in human in voiding and in patients with VD. RECENT FINDINGS: The current understanding of brain centers, and their roles in initiating, maintaining and/or modulating voiding, is rudimentary in humans and in patients with VD. With the advent and advancement in functional neuroimaging we are gaining more insight into specific brain regions involved in the voiding phase of micturition. In healthy individuals, right dorsomedial pontine tegmentum, periaqueductal grey, hypothalamus, and the inferior, medial and superior frontal gyrus have been identified as regions of interest in voiding. SUMMARY: Functional neuroimaging could suggest new diagnostic methods and provides crucial steps towards therapeutic options for the morbid and intractable VD condition, in patients with neurogenic (e.g. MS or Strokes) or non-neurogenic VD (e.g. underactive bladder or Fowler's syndrome).
PURPOSE OF REVIEW: Voiding dysfunction (VD) is morbid, costly, and leads to urinary tract infections, stones, sepsis, and permanent renal failure. Evaluation and diagnosis of VD in non-obstructed patients can be challenging. Potential diagnostic and therapeutic options beyond the bladder, such as brain centers involved in voiding have been proposed as promising targets. This review focuses on current and future applications of functional neuroimaging in human in voiding and in patients with VD. RECENT FINDINGS: The current understanding of brain centers, and their roles in initiating, maintaining and/or modulating voiding, is rudimentary in humans and in patients with VD. With the advent and advancement in functional neuroimaging we are gaining more insight into specific brain regions involved in the voiding phase of micturition. In healthy individuals, right dorsomedial pontine tegmentum, periaqueductal grey, hypothalamus, and the inferior, medial and superior frontal gyrus have been identified as regions of interest in voiding. SUMMARY: Functional neuroimaging could suggest new diagnostic methods and provides crucial steps towards therapeutic options for the morbid and intractable VD condition, in patients with neurogenic (e.g. MS or Strokes) or non-neurogenic VD (e.g. underactive bladder or Fowler's syndrome).
Authors: Bahareh Vahabi; Adrian S Wagg; Peter F W M Rosier; Kevin L J Rademakers; Marie-Astrid Denys; Michel Pontari; Thelma Lovick; Francoise A Valentini; Pierre P Nelson; Karl-Erik Andersson; Christopher H Fry Journal: Neurourol Urodyn Date: 2017-04 Impact factor: 2.696
Authors: Holly A Roy; Debbie Pond; Christopher Roy; Beth Forrow; Thomas Foltynie; Ludvic Zrinzo; Harith Akram; Tipu Z Aziz; James J FitzGerald; Alexander L Green Journal: Neurourol Urodyn Date: 2017-06-12 Impact factor: 2.696
Authors: Natalia M Kleinhans; Claire C Yang; Eric D Strachan; Dedra S Buchwald; Kenneth R Maravilla Journal: J Urol Date: 2015-10-22 Impact factor: 7.450
Authors: Mary F Barbe; Sandra Gomez-Amaya; Alan S Braverman; Justin M Brown; Neil S Lamarre; Vicky S Massicotte; Jennifer K S Lewis; Stephen R Dachert; Michael R Ruggieri Journal: Neurourol Urodyn Date: 2015-10-09 Impact factor: 2.696
Authors: Stephanie C Knüpfer; Martina D Liechti; Livio Mordasini; Dominik Abt; Daniel S Engeler; Jens Wöllner; Jürgen Pannek; Bernhard Kiss; Fiona C Burkhard; Marc P Schneider; Elena Miramontes; Alfons G Kessels; Lucas M Bachmann; Thomas M Kessler Journal: BMC Urol Date: 2014-08-13 Impact factor: 2.264