ATP release during bladder filling in women with bladder oversensitivity
INTRODUCTION AND OBJECTIVES: Patients with bladder oversensitivity (80) (previously called painful bladder syndrome, PBS) suffer from urgency and frequency, often accompanied by suprapubic pain. Because ATP is an important sig nall ing molecule in bladder fun ction and dysfunction, ATP might playa unique role in women wi th 80. Our aim was to investigate the correlati on between ATP release and urodynamic parameters, Le., first desire to void (FDV) and maximum cystometry capacity (MCG) in BO patients, as welt as urine pH. METHODS: Routine cystometry was performed in a consecutive series of 237 women, 28 women were diagnosed wi th BO. 4 patients with urinary tract infection were excluded . The voided urodynamic fluid was stored at -200C and ATP measured using a bioluminescence assay. Midstream urine was collected for pH measurement. Statistical analysis was performed using GraphPad Pri sm 5.0 software. Correlations between two factors were tested by linear regression analysis. RESULTS: There was a significan t reverse correlation between the concentration of ATP in bladder washings and FDV (r2= 0.25; P= 0.013) (Fig 1). The correlation between ATP concentration and MCC (P= 0.32) or voided volume (W) (P = 0.31) was not significant. There was a significant reverse correlation between ATP concentration in voided urodynamic fluid and the urine pH (Fig 2). CONCLUSIONS: ATP is an important factor for initial perception of need to urinate (as indicated by FDV). This is similar to our previous findings in patients with detrusor overactivity, suggesting that ATP may mediate initial afferent sensation in patien ts with bladder dysfunctions characterised by urgency. ATP release of BO patients was also strongly affected by their urine pH.