Increase in Urgency Definitely Influences Our Mental Functioning

[icnmgrjill]

Editors Note - Okay.. this is yet another study that makes you go "Of course it does." Imagine having to pee so bad that it hurts. Now imagine that you're supposed to take a test. Do you really think that you're going to perform well in the test when your bladder is throbbing like mad? Of course not.

Here's an interesting editorial by Dr. Phil Hanno about a study that found that urinary urgency can be so distracting that it's equivalent to drinking a modest level of alcohol or going without a nights rest. Ummm... as an IC patient, I can definitely see that severe flares have made it difficult for me to function, period. What I don't want this to imply, however, is that we aren't as smart as we should be. We're hurt... people who are hurt logically do have problems functioning at time. Nuff said - Jill



Editor's Commentary - The effect of acute increase in urge to void on cognitive function in healthy adults
Tue, 12 April 2011 | Philip M. Hanno, MD

BERKELEY, CA (UroToday.com) -
Acute Increase in Urge Shown to Affect Cognitive Function
Functionally, the urinary system acts in a straightforward manner whereby the bladder fills to a threshold and then an urge to void is initiated with micturition occurring soon thereafter. In healthy adults, the retention of urine is associated with increased bladder pressure that can lead to sensations of pain. There are three distinct sensations associated with bladder filling. The sensation of filling is followed by an experience of the urge to void, followed by a strong urge to void. The urge to void and pain abate with micturition. Prolongation of the time to void beyond these phases gives rise to sensations of pain and increased sensation of urgency to void, as anyone with IC/BPS knows only too well.

If the symptoms of IC/BPS are an exaggeration of the normal urge and discomfort with a “full” bladder that results in micturition, then the findings of Lewis and colleagues from Melbourne, Australia and Connecticut and Rhode Island deserve a careful look. Acute pain and distraction arising from somatic signals can interfere with cognitive function in otherwise healthy adults. The authors note that common anterior cortical regions in the control of pain and aspects of cognitive function, such as attention and working memory. Currently there are no data available on the cognitive effects of voluntary inhibition of the urge to void.

Lewis and coworkers had 8 healthy young adults consume 250ml of water every 15 minutes until they could no longer inhibit voiding. Performance on standardized measures of cognitive function was measured at hourly intervals which were classified as baseline, when individuals reported an increase in the urge to void, a strong increase in the urge to void, an extreme increase in the urge to void, and post micturition. They found that sensations of the urge to void and pain increased with time of inhibition of the urge to void and with amount of water consumed. Having an extreme urge to void exerted a large negative effect on attentional and working memory functions. The magnitude of deterioration associated with the extreme urge to void was equivalent to that observed in adults with a blood alcohol level of 0.05% or that observed after 24 hours of sustained wakefulness.

I found this study to be very interesting. If you combine the repeated severe urge and pelvic pain seen in some patients with IC/BPS with lack of sleep from nocturia, one could anticipate similar cognitive impairment during acute exacerbations of the disorder. Further work on this aspect could be illuminating.

Lewis MS, Snyder PJ, Pietrzak RH, Darby D, Feldman RA, Maruff P
Neurourol Urodyn. 2011 Jan;30(1):183-7.
10.1002/nau.20963
PubMed Abstract
PMID: 21058363

[pal2pah]

I always wonder why so many studies are done testing hypothesis' that are so obvious? Even a person who has never had a bladder problem would realize that it would be distracting to have an overly full bladder. They would certainly realize that adding pain to the equation would make concentration harder. So much research is needed that I find it annoying when time and money is wasted on so called studies with the -Dah- factor (so obvious that it's insulting).

pal3pah
Patty

[ICNDonna]

It's always better to have proof, even if some things might seem to be obvious --- I know that people with healthy bladders absolutely cannot understand how it feels to have a full bladder if you have IC. If there's recorded "proof" it does help all of us.

Donna

[kadi]

It also helps to have these studies to convince people to award grant money for research.
That said, my first reaction to results like this is usually "Well, duh!...." And I wish we were farther along in finding more effective treatments and a cure.

[Trishann]

I am glad that is finally getting out!

[icnmgrjill]

:::rolls eyes::: LOL! I agree with you all!