Urethral and Bladder Current Perception Thresholds: Normative Data in Women

Purpose: Given increased evidence of sensory dysfunction in lower urinary tract pathology, we determined normative current perception threshold values in the lower urinary tract of asymptomatic women. Materials and Methods: After receiving institutional review board approval women without lower urinary tract symptoms underwent current perception threshold testing of the urethra and bladder using a Neurometer® constant current stimulator. Current perception threshold values were determined at 3 frequencies, including 2,000 Hz (corresponding to A-β fibers), 250 Hz (corresponding to A-δ fibers) and 5 Hz (corresponding to C fibers). Results: A total of 48 women with a mean age of 38 years (range 23 to 67) underwent current perception threshold testing. Normative values were established for the urethra and bladder at 2,000, 250 and 5 Hz. Median urethral current perception thresholds at 2,000, 250 and 5 Hz were 1.2 (IQR 0.76-1.5), 0.45 (IQR 0.33-0.56) and 0.11 mA (IQR 0.07-0.24), respectively. Median bladder current perception thresholds at 2,000, 250 and 5 Hz were 4.1 (IQR 2.0-6.3), 2.3 (IQR 0.87-5.5) and 1.4 mA (IQR 0.22-2.9), respectively. Urethral and bladder current perception thresholds increased significantly with subject age at all 3 frequencies (p <0.0005). Prior pelvic surgery was associated with an increased bladder current perception threshold at all 3 frequencies (p <0.005) but not with the urethral current perception threshold. Conclusions: We report urethral and bladder current perception thresholds for a large sample of asymptomatic women. These reference values may help elucidate changes in afferent nerve function in women with lower urinary tract dysfunction.