Association between overactive bladder and pelvic organ mobility as evaluated by dynamic magnetic resonance imaging

Kurenai Kinno,Yoshitomo Sawada,Shoutarou Watanabe,Yasuharu Takeuchi,Noritoshi Sekido,Yasukuni Yoshimura

doi:10.1038/s41598-021-93143-6

Kurenai Kinno, Yoshitomo Sawada + Show 4 more

Open Access

https://doi.org/10.1038/s41598-021-93143-6

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Abstract

Overactive bladder (OAB) is a prevalent condition, which negatively impacts patients’ quality of life. Pelvic organ prolapse (POP), also prevalent in women, has been recognized as an important etiology of female OAB, although the pathophysiological mechanisms remain controversial. In this study, we reviewed findings of dynamic magnetic resonance imaging (dMRI) in 118 patients with POP and investigated the association between dMRI findings, including positions and mobilities of pelvic organs as well as parameters of pelvic organ support and bladder outlet obstruction (urethral kinking), and OAB in order to elucidate the pathophysiology of OAB in patients with POP. Our results showed that compared with non-OAB patients, OAB patients had a significantly higher body mass index, more severe pelvic floor muscle impairment, and more profound supportive defects in the uterine cervix (apical compartment). On the other hand, dMRI parameters showed hardly any significant difference between patients with mild and moderate to severe OAB. These findings may imply that levator ani impairment and defective supports of the apical compartment could be associated with the presence of OAB and that the severity of OAB could be affected by factors other than those related to pelvic organ mobility and support or urethral kinking.

Highlights

Overactive bladder (OAB) is a prevalent condition, which negatively impacts patients’ quality of life
We demonstrated that body mass index (BMI), smoking status, levator ani impairment, and defective supports of the apical compartment were associated with the presence of OAB
This implies that female OAB may be derived from a ligamentous–fascial disorder remote from the symptomatic o rgan[16], which could explain why supports for an apical compartment, rather than the positions and pelvic organ mobility (POM) of the bladder neck (BN) or the most dependent position of the bladder (B), are significantly associated with the presence of OAB in the present study

Summary

Introduction

Overactive bladder (OAB) is a prevalent condition, which negatively impacts patients’ quality of life. Remains to be determined which compartment should be repaired in order to sufficiently improve OAB To this end, investigating the association between the condition of pelvic organs as well as their supporting tissues and OAB by imaging studies may shed light on the pathophysiology of OAB in patients with POP, which may guide the selection of appropriate treatment. To elucidate the pathophysiology of OAB in patients with POP, we investigated the association between parameters including pelvic organ positions and POMs derived from dMRI findings and the presence of OAB as well as its severity by the use of an OAB symptom score, O ABSS20

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