Bladder Sensation

Measurement of sensation during cystometry is subjective and variable. Sensitivity and functional capacity are best determined with voiding diaries and not by CMG. The first sensation is the first awareness of filling, and is considerably variable. Many patients describe a filling sensation immediately. Typically, the first sensation to urinate is felt at 90 to 150 mL. The normal desire to void is the feeling that leads the patient to pass urine at the next convenient moment, but when voiding can be delayed if necessary. A strong desire to void is felt when there is a persistent urge to void without the fear of leakage. Urgency is a strong desire to void accompanied by fear of leakage or pain. Urgency is felt at 200 to 400 mL and bladder fullness occurs at 300 to 600 mL. Pain during bladder filling or micturition is abnormal.

Early sensations of filling (sensory urgency) may indicate inflammation, unstable detrusor contractions, or decreased bladder compliance. Delayed sensations of filling may represent a neurologic disorder such as peripheral neuropathy of the pelvic plexus, trauma, or disease affecting the sacral nerves.

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