International Neurourology Journal最新文献

{"title":"Prevalence of Detrusor After-Contraction and Concomitant Urodynamic Findings: A Systematic Review and Exploratory Analysis of an Understudied Urodynamic Phenomenon.","authors":"Alfredo Salazar Monroy, Jesús Héctor Cantú Elizondo, Arturo Pacheco Silva","doi":"10.5213/inj.2652222.111","DOIUrl":"https://doi.org/10.5213/inj.2652222.111","url":null,"abstract":"<p><strong>Purpose: </strong>Detrusor after-contraction (DAC) is a urodynamic phenomenon whose clinical relevance remains contested, largely because no formal operational definition has been established. We conducted the first systematic review of DAC to characterize the definitional and methodological heterogeneity underlying its reported prevalence and its co-occurrence with other urodynamic findings. Exploratory quantitative pooling was performed to illustrate the magnitude of this heterogeneity, not to establish a clinically generalizable prevalence estimate.</p><p><strong>Methods: </strong>PubMed and Scopus were searched from inception through February 2026 (PROSPERO: CRD420251131496). Studies reporting DAC prevalence with extractable numerator/denominator data in mostly adult (≥18 years), non-neurogenic populations were included. Pooled estimates were calculated using random-effects models with logit transformation and Hartung-Knapp adjustment. Risk of bias was assessed using a checklist adapted from the JBI Critical Appraisal Checklist.</p><p><strong>Results: </strong>Five studies (n = 7,131 patients) were included, applying at least four distinct operational definitions of DAC. Between-study heterogeneity was extreme (I² = 98.2%); an exploratory pooled DAC prevalence of 12.98% (95% CI 4.80-30.62%) is reported to illustrate this instability, with a 95% prediction interval (1.06-67.54%) spanning nearly the entire plausible range of proportions. Among DAC-positive patients, detrusor overactivity co-occurred in an exploratory pooled proportion of 48.57% (95% CI 25.50-72.26%; I² = 81.9%); in the absence of a DAC-negative comparator, this reflects co-occurrence rather than a demonstrated association. Pooled estimation of bladder outlet obstruction was not undertaken given incompatible definitional criteria across the only two studies providing extractable data (16.7% vs. 77.8%).</p><p><strong>Conclusions: </strong>The principal contribution of this review is the substantial definitional and methodological heterogeneity across studies of DAC, which precludes a clinically generalizable prevalence estimate. Detrusor overactivity co-occurs in approximately half of DAC-positive patients, an observation that warrants investigation with DAC-negative comparators before causal or associative interpretations can be drawn. Adoption of a uniform operational definition is necessary before meaningful comparisons across cohorts can be achieved.</p>","PeriodicalId":14466,"journal":{"name":"International Neurourology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Orexin Receptor Antagonists on Nocturia and Overactive Bladder Symptoms in Patients with Insomnia: A Single-Center Retrospective Study.","authors":"Yoshikazu Togo, Shimpei Yoshioka, Yohei Kaizuka, Seiji Nagasawa","doi":"10.5213/inj.2652152.076","DOIUrl":"https://doi.org/10.5213/inj.2652152.076","url":null,"abstract":"<p><strong>Purpose: </strong>Although orexin receptor antagonists (ORAs) are widely prescribed for insomnia, experimental studies have suggested that these agents may prolong intervals between bladder contractions. This study investigated the hypothesis-generating associations between ORA treatment and improvements in nocturia and overactive bladder symptoms in patients with insomnia.</p><p><strong>Methods: </strong>Enrolled were 45 patients who visited our hospital between September 2022 and December 2025 with nocturia as their main complaint and experienced two or more nighttime urinations. All had overactive bladder symptoms defined as a urinary urgency score ≥2 and total score ≥3 based on the Overactive Bladder Symptom Score (OABSS), as well as insomnia. They were treated with ORAs for 4 weeks, with OABSS scores and postvoid residual urine volume evaluated before and 4 weeks after starting treatment.</p><p><strong>Results: </strong>There were 39 males and 6 females, with a mean age of 76.2 years. Overactive bladder severity was categorized as mild in 5 patients, moderate in 35, and severe in 5. The total OABSS score decreased significantly following ORA treatment, from 8.1 to 6.2 (P <0.001). Analysis of each OABSS domain showed significant reductions in daytime frequency (1.1 to 0.9, P <0.05), nighttime frequency (2.8 to 2.2, P <0.001), urgency score (3.0 to 2.1, P <0.001), and urge urinary incontinence (1.2 to 0.9, P <0.01) scores. In contrast, postvoid residual urine volume did not increase significantly after treatment (P = 0.83).</p><p><strong>Conclusions: </strong>ORA treatment was found to be effective and safe in insomnia patients with nocturia. The findings suggest that ORAs may improve nocturia and OAB symptoms in patients with insomnia.</p>","PeriodicalId":14466,"journal":{"name":"International Neurourology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serotonergic Transmission in the Hippocampus Is Subject to Multifaceted Modulation by Other Neurotransmitters.","authors":"Jae Heon Kim, Miho Song, Chan Young Lee, Yun Seob Song","doi":"10.5213/inj.2550346.173","DOIUrl":"10.5213/inj.2550346.173","url":null,"abstract":"<p><strong>Purpose: </strong>Serotonin (5-HT) release in the hippocampus is modulated by N-methyl-D-aspartate (NMDA) receptor activity, particularly under hypoxic conditions, but the roles of other neurotransmitter systems remain unclear. This study examined how several neurotransmitters affect spontaneous 5-HT release in rat hippocampal slices and whether these effects are direct or interneuron-mediated.</p><p><strong>Methods: </strong>Rat hippocampal slices (400 μm) were preloaded with [3H]5-HT and superfused with oxygenated buffer. Acetylcholine (ACh), norepinephrine (NE), dopamine (DA), NMDA, γ-aminobutyric acid (GABA), glycine, or neuropeptide Y (NPY) were applied for 20 minutes, and [3H]5-HT release was measured in 10-minute fractions. Tetrodotoxin (TTX) was used in parallel experiments to block action potential-dependent neurotransmission.</p><p><strong>Results: </strong>In control slices, spontaneous [3H]5-HT release reached a stable baseline after approximately 50 minutes of superfusion. ACh (10-5M), GABA (10-5M), glycine (10-5M), and NPY (10-6M) did not significantly affect 5-HT release relative to control. In contrast, NE (10-5M) and DA (10-5M) significantly increased 5-HT release (peaking at ~15%-37% above baseline, P<0.05), and these effects persisted in the presence of TTX, suggesting a direct action on serotonergic terminals. NMDA (10-4M) also transiently enhanced 5-HT release (~22% above baseline, P<0.05), but this effect was completely abolished by TTX, indicating reliance on interneuronal activity.</p><p><strong>Conclusion: </strong>Hippocampal 5-HT release is differentially regulated by neurotransmitter systems: NE and DA act directly at serotonergic terminals, whereas NMDA's effect requires interneuronal activity. These findings highlight complex neurochemical interactions that may underlie serotonergic modulation in neuropsychiatric disorders.</p>","PeriodicalId":14466,"journal":{"name":"International Neurourology Journal","volume":"30 3","pages":"214-223"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI-Directed Research and the Loss of Scientific Direction.","authors":"Jin Wook Kim","doi":"10.5213/inj.2626edi03","DOIUrl":"10.5213/inj.2626edi03","url":null,"abstract":"","PeriodicalId":14466,"journal":{"name":"International Neurourology Journal","volume":"30 3","pages":"173-177"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Oxytocin on Rats With Stress-Induced Increased Urinary Frequency.","authors":"Saori Nishijima, Katsumi Kadekawa, Katsuhiro Ashitomi, Seiji Matsumoto, Kimio Sugaya","doi":"10.5213/inj.2550358.179","DOIUrl":"10.5213/inj.2550358.179","url":null,"abstract":"<p><strong>Purpose: </strong>Urinary frequency and bladder hypersensitivity are among the lower urinary tract symptoms exacerbated by psychological stress. This study investigated whether chronic oxytocin (OXT) administration could alleviate stress-induced bladder dysfunction and modulate central stress pathways.</p><p><strong>Methods: </strong>Female Sprague-Dawley rats were allocated to control, stress, or stress/OXT groups (n=14 per group) and exposed to repeated variable stress (RVS) for 1 week. Assessments included mechanical sensitivity, cystometric parameters, plasma catecholamine and cortisol levels, bladder histology, c-Fos expression in the paraventricular nucleus (PVN), and gene expression in bladder and brain regions.</p><p><strong>Results: </strong>RVS induced mechanical hypersensitivity, reduced intercontraction intervals, increased bladder weight, and raised plasma adrenaline, dopamine, and cortisol levels. The bladder also showed epithelial thickening, submucosal nerve hyperplasia, and increased prostaglandin E receptor 3 and epithelial sodium channel expression. Stress significantly enhanced PVN activation and increased brainstem expression of choline acetyltransferase, corticotropin-releasing factor, and tyrosine hydroxylase. With OXT treatment, intercontraction intervals normalized, catecholamine and cortisol levels declined, PVN c-Fos activation decreased, and OXT receptor expression increased in the brainstem, hypothalamus, and thalamus, and glutamate decarboxylase 1 expression increased in the hypothalamus and thalamus. Interleukin-6 expression decreased with OXT treatment but did not change in response to stress.</p><p><strong>Conclusion: </strong>Chronic OXT administration was associated with improved stress-induced urinary frequency and modulation of central stress pathways; evidence of direct peripheral anti-inflammatory effects was limited.</p>","PeriodicalId":14466,"journal":{"name":"International Neurourology Journal","volume":" ","pages":"224-232"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Afferent Threshold Hypothesis: A Unified Neural Framework for Functional Bladder Capacity and Nocturia.","authors":"Jin Wook Kim","doi":"10.5213/inj.2652082.041","DOIUrl":"10.5213/inj.2652082.041","url":null,"abstract":"<p><p>The Weiss nocturia indices have structured clinical thinking about nocturia for over 2 decades. By deriving simple ratios from the frequency-volume chart, they classify nocturia into nocturnal polyuria, reduced nocturnal bladder capacity, and mixed etiology. The arithmetic is sound. But the framework rests on an unexamined assumption: that the maximum voided volume, almost always the first morning void, represents \"bladder capacity,\" and that the gap between this value and daytime voided volumes reflects normal physiology. We propose that what the frequency-volume chart measures during wakefulness is not capacity but a personal adaptive afferent threshold-a neurally determined set-point at which the individual initiates voiding, always below the structural capacity the detrusor permits. The first morning void approximates true structural capacity, revealed when sleep suppresses the cortical circuits that enforce the waking threshold. This reframing unifies the entire overactive bladder spectrum-normal voiding, frequency, urgency, urge incontinence-as positions on a single threshold continuum. It reveals nocturia from \"reduced nocturnal bladder capacity\" as the intrusion of the waking threshold into sleep when central afferent gating fails. The Weiss parameters captured the output of this system with numerical precision but encoded the threshold artifact as the reference norm, directing a generation of research toward the bladder in patients whose problem may be the brain.</p>","PeriodicalId":14466,"journal":{"name":"International Neurourology Journal","volume":"30 3","pages":"192-204"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise-Induced Activation of IGF-1/mTOR Signaling and Hippocampal BDNF/PGC-1α Expression Reverses Age-Related Motor Decline.","authors":"Taewan Kim, Jinkyung Cho, Yoonhwan Kim, Sang Koo Woo, Donghyun Kim","doi":"10.5213/inj.2652056.028","DOIUrl":"10.5213/inj.2652056.028","url":null,"abstract":"<p><strong>Purpose: </strong>Aging is associated with a progressive decline in skeletal muscle function and motor coordination, contributing to reduced mobility and quality of life. While exercise is a well-established intervention to counteract age-related deterioration, the underlying molecular mechanisms in both muscle and the brain remain incompletely understood.</p><p><strong>Methods: </strong>Young (4 months) and aged (20 months) male C57BL/6N mice were assigned to control or treadmill exercise groups. After 8 weeks of training, the grip strength, muscle histology, rotarod performance, and molecular markers related to muscle hypertrophy and brain plasticity were analyzed.</p><p><strong>Results: </strong>Treadmill exercise significantly increased grip strength in both young and aged mice without changes in muscle fiber size, indicating improved muscle quality. Molecular analysis revealed upregulation of insulin-like growth factor 1/AKT/mammalian target of rapamycin (mTOR) and mTOR/p70 ribosomal protein S6 kinase signaling in both young and aged mice. Exercise also modulated myogenic markers in an age-dependent manner, increasing paired box 3 (Pax3) and myogenic differentiation 1 in aged mice and Pax7 in young mice. Rotarod performance significantly improved over time, suggesting enhanced motor coordination and learning. These functional gains were accompanied by elevated hippocampal brain-derived neurotrophic factor and peroxisome proliferator-activated receptor gamma coactivator 1-alpha expression.</p><p><strong>Conclusion: </strong>Eight weeks of treadmill exercise enhances muscle strength and motor performance in both young and aged mice. These benefits occur independently of muscle hypertrophy and are associated with favorable molecular adaptations in muscle and the brain. These findings underscore the potential of exercise to preserve neuromuscular function during aging through peripheral and central mechanisms.</p>","PeriodicalId":14466,"journal":{"name":"International Neurourology Journal","volume":"30 3","pages":"243-253"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Assessment for Upper Urinary Tract Deterioration in Patients With Neurogenic Bladder: A Retrospective Study Using Interpretable Machine Learning Algorithms.","authors":"Ping Zhong, Xin Liu, Tianyu Xiang, Juan Wu, Limin Liao","doi":"10.5213/inj.2652084.042","DOIUrl":"10.5213/inj.2652084.042","url":null,"abstract":"<p><strong>Purpose: </strong>Upper urinary tract deterioration (UUTD) is a burdensome complication in patients with neurogenic bladder (NB). This study aimed to develop a practical machine learning (ML) tool for assessing UUTD risk.</p><p><strong>Methods: </strong>The study included 2,393 patients with NB who underwent clinical and urodynamic examinations. Of these, 2,001 patients from northern regions of our country were assigned to training and validation sets, and 392 patients from southern regions formed the test set for internal-external validation. Clinical and urodynamic parameters were screened using the Boruta, least absolute shrinkage and selection operator regression, and decision tree algorithms; features identified by all 3 algorithms were used to develop the ML models. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC), calibration curves, and decision curve analysis. SHapley Additive exPlanations analysis provided visual interpretations for individual patients.</p><p><strong>Results: </strong>Six features, notably bladder management method and detrusor sphincter dyssynergia, were identified as risk factors for UUTD. Of the 4 ML algorithms, the Gaussian Naive Bayes (GNB) model had the best overall performance, with AUCs (95% confidence intervals) of 0.884 (0.867-0.901), 0.868 (0.829-0.907), and 0.878 (0.839-0.916) in the training, validation, and test sets, respectively. Subgroup analyses by imaging outcome, NB etiology, and age showed consistent performance of the GNB model, with AUCs ranging from 0.815 to 0.895. The GNB model incorporating the core variables was presented through a practical web-based tool for individualized risk assessment.</p><p><strong>Conclusion: </strong>We developed a ML model to assess UUTD risk in patients with NB. The findings emphasize the importance of combining bladder management method with urodynamic evaluation when assessing UUTD risk, and the model provides a practical tool for individualized assessment. Independent external validation of the model is warranted.</p>","PeriodicalId":14466,"journal":{"name":"International Neurourology Journal","volume":" ","pages":"266-279"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modulating Secondary Inflammation After Spinal Cord Injury Affects Pathological Bladder Remodeling.","authors":"Michael Kleindorfer, Karin Roider, Katia Monastyrskaia, Akshay Akshay, Patrick Heimel, David Hercher, Evelyn Beyerer, Sophina Bauer, Martha Georgina Bradtner, Lukas Lusuardi, Ludwig Aigner, Elena Esra Keller","doi":"10.5213/inj.2652074.037","DOIUrl":"10.5213/inj.2652074.037","url":null,"abstract":"<p><strong>Purpose: </strong>Neurogenic lower urinary tract dysfunction (nLUTD) develops in nearly all patients after spinal cord injury (SCI). Evolving neuroinflammation is considered a key driver of secondary injury and is associated with worsening outcomes. However, few studies have examined treatments for nLUTD after SCI that specifically target these processes. This study investigated whether early montelukast therapy targeting proinflammatory leukotrienes improves long-term urological function and reduces pathological bladder remodeling.</p><p><strong>Methods: </strong>Female Lewis rats received a permanently implanted urinary catheter and underwent contusion SCI (Th8/Th9) or sham surgery. Daily montelukast treatment began 1 day after injury and continued throughout the 2- or 6-month follow-up period. Injury severity and regeneration were evaluated using the Basso-Beattie-Bresnahan locomotor score and microcomputed tomography of the spinal cord. Bladder function was assessed through weekly urodynamic recordings in awake animals, and bladder structure was assessed by histological measurement of wall thickness. Transcriptomic and proteomic analyses were used to characterize the molecular processes underlying bladder remodeling.</p><p><strong>Results: </strong>Spinal cord tissue damage and functional impairment were comparable across animals, regardless of treatment. Montelukast did not improve urodynamic outcomes and was associated with transiently poorer functional scores during early recovery. Bladder wall thickness increased after SCI and was greatest in the treated groups, suggesting ongoing remodeling. Transcriptomic and proteomic analyses demonstrated marked activation of immune and contractility-related pathways in treated animals at 2 months. Animals followed for the longer period showed intensified immune signaling, indicating sustained inflammatory activity.</p><p><strong>Conclusion: </strong>Early montelukast treatment did not improve functional or structural urological outcomes after contusion SCI. The unfavorable functional trends and intensified inflammatory and injury-related pathways suggested adverse effects rather than therapeutic benefit under the conditions studied. These findings may indicate the importance of injury model-specific mechanisms and of dose and timing when developing anti-inflammatory strategies for SCI-induced nLUTD.</p>","PeriodicalId":14466,"journal":{"name":"International Neurourology Journal","volume":"30 3","pages":"254-265"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential Effects of Antidepressants on Hypothalamic Serotonin Levels in Rats: An In Vivo Microdialysis Study.","authors":"Jae Heon Kim, Hyung Gun Kim, Miho Song, Chan Young Lee, Yun Seob Song","doi":"10.5213/inj.2550268.134","DOIUrl":"10.5213/inj.2550268.134","url":null,"abstract":"<p><strong>Purpose: </strong>Antidepressants can induce urinary retention, difficulty in voiding, and delayed micturition, effects thought to result from detrusor relaxation and increased urethral sphincter tone mediated by enhanced central serotonergic activity. However, direct measurements of brain serotonin following antidepressant treatment remain limited. The relative risk of voiding difficulty across different antidepressant classes may help guide individualized antidepressant selection. This study aimed to assess changes in hypothalamic serotonin levels after administration of various antidepressants using an animal microdialysis model.</p><p><strong>Methods: </strong>Male Sprague-Dawley rats (280-330 g) were randomly assigned to 5 groups (n=8 per group) and received intraperitoneal injections of saline, clomipramine, fluoxetine, sertraline, or paroxetine (10 mg/kg). A microdialysis probe was stereotaxically implanted in the hypothalamus and perfused with artificial cerebrospinal fluid. Dialysate samples were collected every 20 minutes in freely moving animals and analyzed for serotonin levels via high-performance liquid chromatography with electrochemical detection.</p><p><strong>Results: </strong>All tested antidepressants significantly elevated extracellular serotonin in the hypothalamus compared to baseline. The magnitude of increase was greatest with clomipramine, followed by sertraline, paroxetine, and fluoxetine. Peak serotonin levels were observed at 120 minutes post-administration for clomipramine and sertraline, whereas paroxetine and fluoxetine peaked at 240 minutes.</p><p><strong>Conclusion: </strong>Antidepressant treatment increases hypothalamic serotonin, with clomipramine and sertraline producing the most pronounced effects. Considering that clomipramine and paroxetine combine high serotonergic elevation with notable anticholinergic activity, these drugs may pose a higher risk of voiding difficulties than fluoxetine or sertraline. This study focused on characterizing central serotonergic responses to antidepressant administration as a neurochemical endpoint. The relative risk of voiding difficulty across different antidepressant classes may help guide individualized antidepressant selection. Clinicians should exercise caution when prescribing these agents to elderly patients, individuals with benign prostatic hyperplasia, or those receiving concurrent anticholinergic medications.</p>","PeriodicalId":14466,"journal":{"name":"International Neurourology Journal","volume":"30 3","pages":"205-213"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}