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Neuroimaging Study Investigating the Supraspinal Control of Lower Urinary Tract Function in Man With Orthotopic Ileal Neobladder

Introduction: Recent studies employing functional imaging methodology have revealed reference brain regions of urinary tract function, namely, the midbrain periaqueductal gray matter, thalamus, and cingulate and prefrontal cortices. The orthotopic ileal neobladder is a desirable method for urinary d...

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Autores principales: Wu, Wanhua, Su, Yun, Huang, Hao, Chen, Meiwei, Fan, Fan, Zhu, Dingjun, Li, Kaiwen, Guo, Zhenghui, Liang, Zhiying, Huang, Hai
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8688399/
https://www.ncbi.nlm.nih.gov/pubmed/34950694
http://dx.doi.org/10.3389/fsurg.2021.751236
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author Wu, Wanhua
Su, Yun
Huang, Hao
Chen, Meiwei
Fan, Fan
Zhu, Dingjun
Li, Kaiwen
Guo, Zhenghui
Liang, Zhiying
Huang, Hai
author_facet Wu, Wanhua
Su, Yun
Huang, Hao
Chen, Meiwei
Fan, Fan
Zhu, Dingjun
Li, Kaiwen
Guo, Zhenghui
Liang, Zhiying
Huang, Hai
author_sort Wu, Wanhua
collection PubMed
description Introduction: Recent studies employing functional imaging methodology have revealed reference brain regions of urinary tract function, namely, the midbrain periaqueductal gray matter, thalamus, and cingulate and prefrontal cortices. The orthotopic ileal neobladder is a desirable method for urinary diversion after radical cystectomy, but its supraspinal control remains unknown. We aimed to evaluate brain activity while maintaining urinary urgency and voluntary urinary control in male subjects with ileal orthotopic neobladders by performing functional MRI (fMRI) during a block design experiment. Materials and Methods: Patients were recruited at the Sun Yat-sen Memorial Hospital of the Sun Yat-sen University from October 2017 to May 2019. Two tasks were performed during fMRI scanning: (1) repeated infusion and withdrawal of sterile saline solution into and out of the neobladder to simulate urgency; and (2) repeated contraction of the pelvic floor muscle with a full neobladder to induce inhibition of micturition since the subjects were asked not to urinate. The obtained data were visualized and statistically analyzed. Results: Sixteen subjects were recruited in the study, and data were obtained from 10 subjects: mean age 60.1 years, average postoperative time 20.2 months, and daytime continence rate 100%. The parahippocampus, frontal lobe, vermis, and anterior cingulate cortex were activated with large bladder volumes, and the thalamus and caudate nucleus were deactivated during voluntary urinary control. Conclusion: A complex supraspinal program is involved during ileal orthotopic neobladder control, which is significantly different from that with normal bladders, in which the original intestine visceral volume sensation is preserved.
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spelling pubmed-86883992021-12-22 Neuroimaging Study Investigating the Supraspinal Control of Lower Urinary Tract Function in Man With Orthotopic Ileal Neobladder Wu, Wanhua Su, Yun Huang, Hao Chen, Meiwei Fan, Fan Zhu, Dingjun Li, Kaiwen Guo, Zhenghui Liang, Zhiying Huang, Hai Front Surg Surgery Introduction: Recent studies employing functional imaging methodology have revealed reference brain regions of urinary tract function, namely, the midbrain periaqueductal gray matter, thalamus, and cingulate and prefrontal cortices. The orthotopic ileal neobladder is a desirable method for urinary diversion after radical cystectomy, but its supraspinal control remains unknown. We aimed to evaluate brain activity while maintaining urinary urgency and voluntary urinary control in male subjects with ileal orthotopic neobladders by performing functional MRI (fMRI) during a block design experiment. Materials and Methods: Patients were recruited at the Sun Yat-sen Memorial Hospital of the Sun Yat-sen University from October 2017 to May 2019. Two tasks were performed during fMRI scanning: (1) repeated infusion and withdrawal of sterile saline solution into and out of the neobladder to simulate urgency; and (2) repeated contraction of the pelvic floor muscle with a full neobladder to induce inhibition of micturition since the subjects were asked not to urinate. The obtained data were visualized and statistically analyzed. Results: Sixteen subjects were recruited in the study, and data were obtained from 10 subjects: mean age 60.1 years, average postoperative time 20.2 months, and daytime continence rate 100%. The parahippocampus, frontal lobe, vermis, and anterior cingulate cortex were activated with large bladder volumes, and the thalamus and caudate nucleus were deactivated during voluntary urinary control. Conclusion: A complex supraspinal program is involved during ileal orthotopic neobladder control, which is significantly different from that with normal bladders, in which the original intestine visceral volume sensation is preserved. Frontiers Media S.A. 2021-12-07 /pmc/articles/PMC8688399/ /pubmed/34950694 http://dx.doi.org/10.3389/fsurg.2021.751236 Text en Copyright © 2021 Wu, Su, Huang, Chen, Fan, Zhu, Li, Guo, Liang and Huang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Surgery
Wu, Wanhua
Su, Yun
Huang, Hao
Chen, Meiwei
Fan, Fan
Zhu, Dingjun
Li, Kaiwen
Guo, Zhenghui
Liang, Zhiying
Huang, Hai
Neuroimaging Study Investigating the Supraspinal Control of Lower Urinary Tract Function in Man With Orthotopic Ileal Neobladder
title Neuroimaging Study Investigating the Supraspinal Control of Lower Urinary Tract Function in Man With Orthotopic Ileal Neobladder
title_full Neuroimaging Study Investigating the Supraspinal Control of Lower Urinary Tract Function in Man With Orthotopic Ileal Neobladder
title_fullStr Neuroimaging Study Investigating the Supraspinal Control of Lower Urinary Tract Function in Man With Orthotopic Ileal Neobladder
title_full_unstemmed Neuroimaging Study Investigating the Supraspinal Control of Lower Urinary Tract Function in Man With Orthotopic Ileal Neobladder
title_short Neuroimaging Study Investigating the Supraspinal Control of Lower Urinary Tract Function in Man With Orthotopic Ileal Neobladder
title_sort neuroimaging study investigating the supraspinal control of lower urinary tract function in man with orthotopic ileal neobladder
topic Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8688399/
https://www.ncbi.nlm.nih.gov/pubmed/34950694
http://dx.doi.org/10.3389/fsurg.2021.751236
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