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      Women Undergoing Third Line Overactive Bladder Treatment Demonstrate Elevated Thermal Temporal Summation

      , , , , , ,
      The Journal of Urology
      Elsevier BV

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          Abstract

          <div class="section"> <a class="named-anchor" id="S1"> <!-- named anchor --> </a> <h5 class="section-title" id="d4743219e164">Purpose</h5> <p id="P1">To determine if women with overactive bladder (OAB) requiring 3rd line therapy demonstrate greater central sensitization, indexed by temporal summation to heat pain stimuli, than those with OAB. </p> </div><div class="section"> <a class="named-anchor" id="S2"> <!-- named anchor --> </a> <h5 class="section-title" id="d4743219e169">Materials and Methods</h5> <p id="P2">We recruited 39 adult women with OAB from the Urology clinic who were planning to undergo interventional therapy for medication refractory OAB with either onabotulinumtoxinA bladder injection or sacral neuromodulation and 55 women with OAB, either newly seen in our Urology clinic or responding to advertisements for study participation. Participants underwent quantitative sensory testing using a thermal temporal summation protocol. The primary study outcome was the degree of temporal summation, as reflected in the magnitude of positive slope of the line fitted to the series of 10 stimuli at a 49°C target temperature. We compared the degree of temporal summation between study groups using linear regression. </p> </div><div class="section"> <a class="named-anchor" id="S3"> <!-- named anchor --> </a> <h5 class="section-title" id="d4743219e174">Results</h5> <p id="P3">Women in the group undergoing 3rd line therapy demonstrated significantly higher standardized temporal summation slopes compared to those in the nontreatment group (beta = 1.57, 95% confidence interval = .18 - 2.96, t = 2.25, p = .027). On exploratory analyses, a history of incontinence surgery or hysterectomy were factors associated with significantly greater temporal summation. </p> </div><div class="section"> <a class="named-anchor" id="S4"> <!-- named anchor --> </a> <h5 class="section-title" id="d4743219e179">Conclusions</h5> <p id="P4">In this study, the degree of temporal summation was elevated in women undergoing 3rd line OAB therapy compared to women with OAB not undergoing 3rd line therapy. These findings suggest there may be pathophysiologic differences, specifically in afferent nerve function and processing, in some women with OAB. </p> </div>

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          Author and article information

          Journal
          The Journal of Urology
          The Journal of Urology
          Elsevier BV
          00225347
          October 2018
          October 2018
          : 200
          : 4
          : 856-861
          Article
          10.1016/j.juro.2018.05.007
          6146049
          29746857
          bf057284-9152-4082-8ed7-b0907d8d79c8
          © 2018

          https://www.elsevier.com/tdm/userlicense/1.0/

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