PD11-05 PRELIMINARY RESULTS OF BASELINE CORTICAL NEURAL ACTIVITY IN MEN WITH BENIGN PROSTATIC HYPERPLASIA AND BLADDER OUTLET OBSTRUCTION

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Basic Research & Pathophysiology (PD11)1 Sep 2021PD11-05 PRELIMINARY RESULTS OF BASELINE CORTICAL NEURAL ACTIVITY IN MEN WITH BENIGN PROSTATIC HYPERPLASIA AND BLADDER OUTLET OBSTRUCTION Ricardo Gonzalez, Logan Hubbard, Khue Tran, Natalia Hernandez, Christof Karmonik, Shi Zhaoyue, and Rose Khavari Ricardo GonzalezRicardo Gonzalez More articles by this author , Logan HubbardLogan Hubbard More articles by this author , Khue TranKhue Tran More articles by this author , Natalia HernandezNatalia Hernandez More articles by this author , Christof KarmonikChristof Karmonik More articles by this author , Shi ZhaoyueShi Zhaoyue More articles by this author , and Rose KhavariRose Khavari More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001986.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Benign prostatic hyperplasia (BPH) affects the entire micturition cycle including filling/storage phases, creating bothersome lower urinary tract symptoms (LUTS). Chronic bladder outlet obstruction (BOO) remodels the entire lower urinary tract including the detrusor, connective tissue and local neural network; yet the extent to which it alters the central nervous system (CNS) in BPH is unknown. This study explores brain activation patterns on fMRI in men with BPH and BOO. METHODS: Men age ≥45 who failed conservative BPH therapy planning to undergo BOO procedures were recruited. Eligible men underwent concurrent fMRI-urodynamics (UDS) examination, their bladder was filled until a strong desire to void was signaled. Subjects were asked to hold for 30 seconds, before receiving permission to void while concurrent UDS was performed. After voiding/attempt to void, the bladder was drained and the cycle was repeated up to four times. fMRI images were obtained via a T1W 3 Tesla MRI. Significant activated voxels (p <0.05) were identified at strong urge to void and voiding initiation/attempt to void. RESULTS: Seven men with baseline demographics are represented in table 1. At strong urge to void, there was activation in the right inferior frontal gyrus (IFG) (p <0.05), fig 1a. Deactivation was seen bilaterally in thalamus, middle frontal gyrus, insula and parahippocampal gyrus, and in left middle/superior temporal gyrus (p <0.05). At voiding initiation activation was seen in the left angular gyrus/superior temporal gyrus, and the IFG, fig 1b. Only four of seven patients were able to void supine during fMRI scan. CONCLUSIONS: This is the first study evaluating cortical activity in men with BPH and BOO. At full urge there was significant activation of the IFG, consistent with data from Harvie et al showing its significance during the voiding phase. However, there were important deactivations including bilateral thalamus, insula, and IFG during initiation and voiding attempts previously shown to be important regions in normal micturition in healthy adults. Further studies should evaluate whether deactivation in these regions reflect the inability to void of multiple subjects and/or represent neuroplastic changes of supraspinal micturition control in response to chronic BOO in men with BPH. Source of Funding: This study is supported by Pilot project funding through University of Pittsburgh O’Brien Cooperative Research Center program U54DK112079. Dr. Khavari is partially supported by K23DK118209, by National Institute of Heath, NIDDK and by Houston Methodist Clinician Scientist Award © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e199-e199 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ricardo Gonzalez More articles by this author Logan Hubbard More articles by this author Khue Tran More articles by this author Natalia Hernandez More articles by this author Christof Karmonik More articles by this author Shi Zhaoyue More articles by this author Rose Khavari More articles by this author Expand All Advertisement Loading ...