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Low amplitude rhythmic contraction frequency in human detrusor strips correlates with phasic intravesical pressure waves

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Abstract

Purpose

Low amplitude rhythmic contractions (LARC) occur in detrusor smooth muscle and may play a role in storage disorders such as overactive bladder and detrusor overactivity. The purpose of this study was to determine whether LARC frequencies identified in vitro from strips of human urinary bladder tissue correlate with in vivo LARC frequencies, visualized as phasic intravesical pressure (p ves) waves during urodynamics (UD).

Methods

After IRB approval, fresh strips of human urinary bladder were obtained from patients. LARC was recorded with tissue strips at low tension (<2 g) and analyzed by fast Fourier transform (FFT) to identify LARC signal frequencies. Blinded UD tracings were retrospectively reviewed for signs of LARC on the p ves tracing during filling and were analyzed via FFT.

Results

Distinct LARC frequencies were identified in 100% of tissue strips (n = 9) obtained with a mean frequency of 1.97 ± 0.47 cycles/min (33 ± 8 mHz). Out of 100 consecutive UD studies reviewed, 35 visually displayed phasic p ves waves. In 12/35 (34%), real p ves signals were present that were independent of abdominal activity. Average UD LARC frequency was 2.34 ± 0.36 cycles/min (39 ± 6 mHz) which was similar to tissue LARC frequencies (p = 0.50). A majority (83%) of the UD cohort with LARC signals also demonstrated detrusor overactivity.

Conclusions

During UD, a subset of patients displayed phasic p ves waves with a distinct rhythmic frequency similar to the in vitro LARC frequency quantified in human urinary bladder tissue strips. Further refinements of this technique may help identify subsets of individuals with LARC—mediated storage disorders.

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Acknowledgements

Funding

Research funding for this study was provided by the Virginia Commonwealth University Presidential Research Quest Fund and National Institute of Health Grant R01DK101719.

Author’s contribution

AF Colhoun helped in protocol/project development, data collection, data analysis and manuscript writing/editing. JE Speich contributed to protocol/project development, data analysis and manuscript writing/editing. LF Cooley contributed to data collection and data analysis. ED Bell helped in data collection. RW Barbee helped in manuscript writing/editing. G Guruli contributed to data collection. PH Ratz contributed to protocol/project development and manuscript writing/editing. AP Klausner helped in protocol/project development, data analysis and manuscript writing/editing.

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Authors and Affiliations

  1. Department of Surgery/Division of Urology, VCU Medical Center, West Hospital, Virginia Commonwealth University School of Medicine, 7th Floor, Room 7205, 1200 East Broad Street, PO Box 980118, Richmond, VA, 23298-0118, USA

    Andrew F. Colhoun, Eugene D. Bell III, Georgi Guruli & Adam P. Klausner

  2. Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University School of Engineering, Richmond, VA, USA

    John E. Speich

  3. Virginia Commonwealth University School of Medicine, Richmond, VA, USA

    Lauren F. Cooley

  4. Department of Emergency Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA, USA

    R. Wayne Barbee

  5. Departments of Biochemistry and Pediatrics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA

    Paul H. Ratz

Authors
  1. Andrew F. Colhoun
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  2. John E. Speich
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  3. Lauren F. Cooley
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  4. Eugene D. Bell III
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  5. R. Wayne Barbee
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  6. Georgi Guruli
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  7. Paul H. Ratz
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  8. Adam P. Klausner
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Corresponding author

Correspondence to Adam P. Klausner.

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Conflict of interest

Drs. Speich and Klausner report funding from the National Institutes of Health. Drs. Colhoun, Cooley, Bell, Barbee, Guruli and Ratz have no disclosures.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. All experiments involving human bladder tissue were approved by the institutional review boards at Virginia Commonwealth University and the Hunter Holmes McGuire Veterans Affairs Medical Center. Informed consent was obtained from all patients involved in this study.

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Colhoun, A.F., Speich, J.E., Cooley, L.F. et al. Low amplitude rhythmic contraction frequency in human detrusor strips correlates with phasic intravesical pressure waves. World J Urol 35, 1255–1260 (2017). https://doi.org/10.1007/s00345-016-1994-0

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  • DOI: https://doi.org/10.1007/s00345-016-1994-0

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