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You have accessJournal of UrologyOriginal Research Articles1 Jan 2024Reply By Authorsis a reply to letterEditorial Comment Ishtiaq Mawla, Andrew Schrepf, Jason J. Kutch, Margaret E. Helmuth, Abigail R. Smith, Eric Ichesco, Claire C. Yang, Victor P. Andreev, Karl J. Kreder, Catherine S. Bradley, Vincent A. Magnotta, Ziya Kirkali, Richard E. Harris, H. Henry Lai, and Steven E. Harte Ishtiaq MawlaIshtiaq Mawla Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan Co-first authors. More articles by this author , Andrew SchrepfAndrew Schrepf Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan Co-first authors. More articles by this author , Jason J. KutchJason J. Kutch Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California More articles by this author , Margaret E. HelmuthMargaret E. Helmuth Arbor Research Collaborative for Health, Ann Arbor, Michigan More articles by this author , Abigail R. SmithAbigail R. Smith Arbor Research Collaborative for Health, Ann Arbor, Michigan More articles by this author , Eric IchescoEric Ichesco Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan More articles by this author , Claire C. YangClaire C. Yang Department of Urology, University of Washington, Seattle, Washington More articles by this author , Victor P. AndreevVictor P. Andreev Arbor Research Collaborative for Health, Ann Arbor, Michigan More articles by this author , Karl J. KrederKarl J. Kreder Department of Urology, University of Iowa Carver College of Medicine, Iowa City, Iowa More articles by this author , Catherine S. BradleyCatherine S. Bradley Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, Iowa More articles by this author , Vincent A. MagnottaVincent A. Magnotta Department of Radiology, University of Iowa, Iowa City, Iowa More articles by this author , Ziya KirkaliZiya Kirkali National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland More articles by this author , Richard E. HarrisRichard E. Harris Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan Susan Samueli Integrative Health Institute, School of Medicine, University of California at Irvine, Irvine, California More articles by this author , H. Henry LaiH. Henry Lai ‡Corresponding Author: H. Henry Lai, MD, Division of Urologic Surgery, 4960 Children’s Pl, Campus Box 8242-0022-02, St Louis, MO 63110 ( E-mail Address: [email protected] Division of Urologic Surgery, Departments of Surgery and Anesthesiology, Washington University in St Louis, St Louis, Missouri Co-senior authors. More articles by this author , and Steven E. HarteSteven E. Harte Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan Co-senior authors. More articles by this author and the LURN Study Group View All Author Informationhttps://doi.org/10.1097/JU.0000000000003699.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Intensity of bladder urgency during naturalistic bladder filling depends on a number of factors, including bladder sensitivity phenotypes and changes in brain connectivity (as reported in this paper),1 the amount and timing of fluid intake, overall fluid status (eg, a dehydrated participant may have slower diuresis in response to fluid challenge), and bladder volume. In a naturalistic bladder-filling paradigm, we have no control over the volume of urine inside the bladder at any given time. Some patients with overactive bladder who did not “respond” to bladder filling (ie, OAB-1 group) and controls may not have done so because their bladder was not full enough to trigger the urgency sensation. Prior naturalistic bladder-filling studies have used higher fluid intake volumes, such as 2000 mL G2-Gatorade (for participants to drink as fast as feasible)2,3 or 600 mL water (for participants to drink within 5 minutes),4 compared with the 350 mL we used in our protocol. However, these studies did not include neuroimaging, which presents unique experimental challenges in regard to fluid volume, intake timing, overall patient burden, and head motion (eg, participant may move inside the MRI scanner if the urgency sensation is too intense). Although some OAB-1 patients may have reported higher urgency ratings with higher fluid intake volumes, many OAB-2 patients (ie, highly responsive subtype predominantly containing overactive bladder) reported mean urgency ratings of 6 out of 10, suggesting the fluid intake volume we used in our protocol was adequate as an urgency trigger. REFERENCES 1. Naturalistic bladder filling reveals subtypes in overactive bladder syndrome that differentially engages urinary urgency-related brain circuits: results from the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN). J Urol. 2024; 211(1):111-123. Link, Google Scholar 2. Non-invasive characterization of real-time bladder sensation using accelerated hydration and a novel sensation meter: an initial experience. Neurourol Urodyn. 2017; 36(5):1417-1426. Crossref, Medline, Google Scholar 3. Comparison of sensation event descriptors in participants with overactive and normal bladders during non-invasive hydration studies. Arch Nephrol Urol Stud. 2021; 1(1):03. Medline, Google Scholar 4. Identification of experimental bladder sensitivity among dysmenorrhea sufferers. Am J Obstet Gynecol. 2018; 219(1):84.e81-84.e88. Crossref, Google Scholar Support: This is publication number 35 of the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN). This study is supported by the National Institute of Diabetes and Digestive and Kidney Diseases through cooperative agreements (Grants DK097780, DK097772, DK097779, DK099932, DK100011, DK100017, DK099879). Research reported in this publication was supported at Northwestern University, in part, by the National Institutes of Health’s National Center for Advancing Translational Sciences (Grant UL1TR001422). Ishtiaq Mawla was supported by F99DK126121 (NIH-NIDDK) training grant. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Conflict of Interest Disclosures: All authors have no conflicts of interest with regard to this manuscript. Ethics Statement: This study received Institutional Review Board approval (IRB No. 00007807). Author Contributions: The authors have followed the practice and ethical guidelines set forth by the International Committee of Medical Journal Editors (ICMJE) and meet the 4 criteria for authorship: Substantial contributions to the conception or design of the work, or the acquisition, analysis, or interpretation of data for the work; and drafting the work or revising it critically for important intellectual content; and final approval of the version to be published; and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Data Availability: The data that support the findings of this study are openly available in the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Central Repository at https://repository.niddk.nih.gov/; please reference the acronym LURN. Clinical Trial Registration No.: NCT02485808. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsRelated articlesJournal of Urology5 Oct 2023Editorial Comment Volume 211 Issue 1 January 2024 Page: 122-123 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.Metrics Author Information Ishtiaq Mawla Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan Co-first authors. More articles by this author Andrew Schrepf Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan Co-first authors. More articles by this author Jason J. Kutch Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California More articles by this author Margaret E. Helmuth Arbor Research Collaborative for Health, Ann Arbor, Michigan More articles by this author Abigail R. Smith Arbor Research Collaborative for Health, Ann Arbor, Michigan More articles by this author Eric Ichesco Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan More articles by this author Claire C. Yang Department of Urology, University of Washington, Seattle, Washington More articles by this author Victor P. Andreev Arbor Research Collaborative for Health, Ann Arbor, Michigan More articles by this author Karl J. Kreder Department of Urology, University of Iowa Carver College of Medicine, Iowa City, Iowa More articles by this author Catherine S. Bradley Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, Iowa More articles by this author Vincent A. Magnotta Department of Radiology, University of Iowa, Iowa City, Iowa More articles by this author Ziya Kirkali National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland More articles by this author Richard E. Harris Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan Susan Samueli Integrative Health Institute, School of Medicine, University of California at Irvine, Irvine, California More articles by this author H. Henry Lai Division of Urologic Surgery, Departments of Surgery and Anesthesiology, Washington University in St Louis, St Louis, Missouri ‡Corresponding Author: H. Henry Lai, MD, Division of Urologic Surgery, 4960 Children’s Pl, Campus Box 8242-0022-02, St Louis, MO 63110 ( E-mail Address: [email protected] Co-senior authors. More articles by this author Steven E. Harte Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan Co-senior authors. More articles by this author Expand All Support: This is publication number 35 of the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN). This study is supported by the National Institute of Diabetes and Digestive and Kidney Diseases through cooperative agreements (Grants DK097780, DK097772, DK097779, DK099932, DK100011, DK100017, DK099879). Research reported in this publication was supported at Northwestern University, in part, by the National Institutes of Health’s National Center for Advancing Translational Sciences (Grant UL1TR001422). Ishtiaq Mawla was supported by F99DK126121 (NIH-NIDDK) training grant. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Conflict of Interest Disclosures: All authors have no conflicts of interest with regard to this manuscript. Ethics Statement: This study received Institutional Review Board approval (IRB No. 00007807). Author Contributions: The authors have followed the practice and ethical guidelines set forth by the International Committee of Medical Journal Editors (ICMJE) and meet the 4 criteria for authorship: Substantial contributions to the conception or design of the work, or the acquisition, analysis, or interpretation of data for the work; and drafting the work or revising it critically for important intellectual content; and final approval of the version to be published; and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Data Availability: The data that support the findings of this study are openly available in the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Central Repository at https://repository.niddk.nih.gov/; please reference the acronym LURN. Clinical Trial Registration No.: NCT02485808. Advertisement Advertisement PDF downloadLoading ...