#0318

Skin Sympathetic Nerve Activity as a Potential Diagnostic Biomarker for Differentiating Detrusor Overactivity, Hypersensitive Bladder, and Bladder Pain Syndrome

Y. Chen¹, H. Chen¹, T. Huang², J. Chen³, W. Tsai²

¹Kaohsiung Medical University Hospital, Kaohsiung Medical University, Department of Urology, Kaohsiung, Taiwan
²Kaohsiung Medical University Hospital, Kaohsiung Medical University, Department of Cardiology, Kaohsiung, Taiwan
³Kaohsiung Medical University, Kaohsiung, Taiwan

Introduction:

Sensory bladder disorders, characterized by symptoms like frequency and urgency, pose diagnostic challenges due to overlapping manifestations. This study aimed to assess autonomic function in female patients with detrusor overactivity (DO), hypersensitive bladder (HSB), and non-Hunner’s interstitial cystitis (NHIC) using a novel non-invasive neuECG method, evaluating whether autonomic parameters can discern these conditions.

Material and methods:

In this prospective study, we enrolled 107 female participants presenting with symptoms of frequency and urgency, excluding those diagnosed with urinary tract infections. Autonomic function was assessed prior to diagnosis and treatment initiation using neuECG, a technique that simultaneously analyzes skin sympathetic nerve activity (SKNA) and heart rate variability (HRV). Diagnoses of DO and HSB were confirmed through urodynamic studies, while IC was diagnosed based on findings from cystoscopic hydrodistension.

Results:

The study comprised 32 participants with DO, 23 with HSB, and 52 with NHIC. Significant findings (Figure 1) revealed that DO had higher SKNA values during stress phases compared to NHIC (p=0.048), and HSB showed a higher stress-to-baseline SKNA ratio and elevated baseline LF/HF ratio versus NHIC (p=0.002 and 0.016, respectively). The SKNA stress-to-baseline ratio provided superior AUROC values for distinguishing between HSB and NHIC (AUROC = 0.755) and DO from HSB (AUROC = 0.711) compared to traditional HRV metrics (Figure 2).