A Study On The Relationship Between Imaging Markers Of Cerebral Small Vessel Disease And Voiding Disorders

BackgroundThe incidence of urinary disorders in the elderly is higher and the nervous system damage is considered an important factor affecting urologic disease.The imaging changes of cerebral small vessel diseases(CSVD)are significance for the early diagnosis of cerebral small vessel disease.However,the relationship between imaging changes of CSVD and urinary complaints is not clear.Therefore,this study aims to explore the distribution of urinary complaints in Chinese patients with CS VD,the relationship between imaging changes and urinary complaints,and improve the early diagnosis of patients with CSVD and the treatment of urinary complaints in patients with CSVD in the future.MethodsIn this study,the clinical information of patients with CSVD from June 2016 to September 2020 in 50 centers in China was included using the database of cerebral small vessel disease cohort study.Questionnaires were used to collect data on urinary complaints,including any form of urinary disorders,incontinence,urgency incontinence,stress incontinence,and daytime urination frequency.The imaging changes included white matter hyperintensities(WMH),paraventricular white matter hyperintensities(PVWMH),deep white matter hyperintensities(DWMH),severe white matter hyperintensities(severe WMH),cerebellar microbleeds(CMBs),basal ganglia microbleeds,brainstem microbleeds,cortical lobular microbleeds,lacunes and total load of CSVD.Severe white matter hyperintensity was defined as WMH with Fazekas score ≥ 2.High load score was defined as total load score of CSVD=3.This study found the related factors of urinary complaints by using univariate analysis,and found the independent risk factors of urinary complaints by using multivariate analysis.ResultsA total of 2784 patients were included in this study.In univariate analysis,the proportion of all imaging changes in the group with any form of urinary complaints was significantly higher than that in the group without urinary complaints.WMH(74.2%vs.64.6%,P=0.01),PVWMH(74.2%vs.63.8%,P=0.005),DWMH(70.2%vs.60.1%,P=0.007),severe white matter hyperintensity(27.0%vs.16.3%,P<0.001),CMBs(39.3%vs.21.7%,P<0.001),high load score(7.3%vs.3.4%,P=0.008)in urgency urinary incontinence group,were significantly higher than those in the non-urgent urinary incontinence group.Daytime urination frequency was correlated with WMH(P=0.016),PVWMH(P=0.002),CMBs(P=0.007),basal ganglia microbleeds(P=0.011),cortical lobe microbleeds(P=0.019)and high load score(P=0.035).In multivariate analysis,severe white matter hyperintensity(OR=1.335,95%CI(1.028-1.733),P=0.030)and CMBS(OR=2.482,95%CI(1.991-3.095),P<0.001)were risk factors for any form of urinary complaints.Severe white matter hyperintensity(OR=1.504,95%CI(1.019-2.219),P=0.040)and CMBS(OR=2.102,95%CI(1.505-2.937),P<0.001)were independently associated with urgency incontinence.Daytime urination frequency was independently correlated with CMBs(>5 times vs.<3 times per day:OR=1.578,95%CI(1.096-2.272),P=0.014).ConclusionResults of our study demonstrated that severe white matter hyperintensity and CMBs were independent risk factors of urinary complaints and urgent incontinence.There was no correlation between lacunes and urgent incontinence.CMBs was a risk factor for increasing daytime urination frequency.The total load of cerebral small vessel diseases was significantly related to urinary complaints.