Volume 42, Issue 1 pp. 17-26

Original Article

Ultrasound-Estimated Bladder Weight Correlates With Videourodynamic Studies in Neurogenic Bladder Dysfunction

Misun Hwang MD,

Misun Hwang MD

Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA

The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

Search for more papers by this author

Susan J. Back MD,

Susan J. Back MD

Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA

The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

Search for more papers by this author

Jason Van Batavia MD,

Jason Van Batavia MD

The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

Division of Urology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA

Search for more papers by this author

Luis Octavio Tierradentro-Garcia MD,

Luis Octavio Tierradentro-Garcia MD

Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA

The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

Search for more papers by this author

Kassa Darge MD, PhD,

Kassa Darge MD, PhD

Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA

The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

Search for more papers by this author

Stephen A. Zderic MD,

Corresponding Author

Stephen A. Zderic MD

[email protected]

orcid.org/0000-0003-3839-7106

The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

Division of Urology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA

Address correspondence to Stephen A. Zderic, MD, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.

E-mail: [email protected]

Search for more papers by this author

Misun Hwang MD,

Misun Hwang MD

Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA

The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

Search for more papers by this author

Susan J. Back MD,

Susan J. Back MD

Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA

The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

Search for more papers by this author

Jason Van Batavia MD,

Jason Van Batavia MD

The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

Division of Urology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA

Search for more papers by this author

Luis Octavio Tierradentro-Garcia MD,

Luis Octavio Tierradentro-Garcia MD

Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA

The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

Search for more papers by this author

Kassa Darge MD, PhD,

Kassa Darge MD, PhD

Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA

The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

Search for more papers by this author

Stephen A. Zderic MD,

Corresponding Author

Stephen A. Zderic MD

[email protected]

orcid.org/0000-0003-3839-7106

The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

Division of Urology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA

Address correspondence to Stephen A. Zderic, MD, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.

E-mail: [email protected]

Search for more papers by this author

First published: 23 April 2022

https://doi.org/10.1002/jum.15995

This work was supported by the John W. Duckett Endowed Chair in Pediatric Urology (S.A.Z.) and the William L. Van Alen Endowed Chair in Pediatric Radiology (K.D.). Drs Zderic and VanBatavia are founders and scientific advisors to UroGenie LLC (UroGenie.com) with support from National Institutes of Health R44 DK127835-01A1. Drs Back and Darge have received educational grant support from Bracco Diagnostics.

Share a link

Email
Wechat
Bluesky

Abstract

Purpose

This retrospective study was designed to evaluate which lower urinary tract ultrasound parameter(s) could predict the results of invasive urodynamic testing which are the current reference standard in the evaluation of bladder dysfunction in children with spina bifida.

Materials and Methods

Fifty eight children with spina bifida undergoing video urodynamic evaluation and a renal bladder ultrasound as their standard of care were evaluated. Quantitative and qualitative ultrasound parameters were then correlated with the videourodynamic study results which served as the reference standard.

Results

For bladders with ending storage pressures above 15 cm H₂O, there were increases in these ultrasound measured parameters: 1) bladder mass (P = .00019), 2) bladder/body mass ratio (P = .0059), and 3) wall thickness (P = .01). We defined the storage cost as the final storage pressure divided by the percentage of expected bladder capacity attained. These data were analyzed to compute receiver operating curves with assuming end storage pressures cutoff points of 15, 20, 30, and 40 cm H₂O. The optimal area under the curve was found for a bladder weight of 65 g and a pressure cutoff of 30 cm H₂O with a sensitivity of 75% with a specificity of 84%.

Conclusion

Bladder weight is independent of luminal volume, can be normalized to body weight, and may serve as a clinically valuable tool for noninvasive screening to define a subset of patients with neurogenic bladder with a higher likelihood of having abnormal videourodynamic results.

References

1Bauer SB. Neurogenic bladder: etiology and assessment. Pediatr Nephrol 2008; 23: 541–551.
10.1007/s00467-008-0764-7
PubMed Web of Science® Google Scholar
2Bauer SB, Austin PF, Rawashdeh YF, et al. International Children's Continence Society's recommendations for initial diagnostic evaluation and follow-up in congenital neuropathic bladder and bowel dysfunction in children. Neurourol Urodyn 2012; 31: 610–614.
10.1002/nau.22247
PubMed Web of Science® Google Scholar
3Kojima M, Inui E, Ochiai A, Kamoi K, Okimura O, Watanabe H. Reversible change of bladder hypertrophy due to benign prostatic hyperplasia after surgical relief of obstruction. J Urol 1997; 158: 89–93.
10.1097/00005392-199707000-00024
CAS PubMed Web of Science® Google Scholar
4Peters CA, Freeman MR, Fernandez CA, Shepard J, Wiederschain DG, Moses MA. Dysregulated proteolytic balance as the basis of excess extracellular matrix in fibrotic disease. Am J Physiol 1997; 272: R1960–R1965.
10.1152/ajpregu.1997.272.6.R1960
CAS PubMed Web of Science® Google Scholar
5Ghafar MA, Anastiasiadis AG, Olsson LE, et al. Hypoxia and an angiogenic response in the partially obstructed rat bladder. Lab Invest 2002; 82: 903–909.
10.1097/01.LAB.0000021135.87203.92
PubMed Web of Science® Google Scholar
6Lassmann J, Sliwoski J, Chang A, Canning DA, Zderic SA. Deletion of one SERCA2 allele confers protection against bladder wall hypertrophy in a murine model of partial bladder outlet obstruction. Am J Physiol Regul Integr Comp Physiol 2008; 294: R58–R65.
10.1152/ajpregu.00477.2007
CAS PubMed Web of Science® Google Scholar
7Chang AY, Butler S, Sliwoski J, Valentino RJ, Canning DA, Zderic SA. Social stress in mice induces voiding dysfunction and bladder wall remodeling. Am J Physiol Renal Physiol 2009; 297: F1101–F1108.
10.1152/ajprenal.90749.2008
CAS PubMed Web of Science® Google Scholar
8Lee YS, Jung HJ, Im YJ, Hong CH, Han SW. The significance of detrusor wall thickness as a prognostic factor in pediatric bladder outlet obstruction. J Pediatr Surg 2012; 47: 1682–1687.
10.1016/j.jpedsurg.2012.03.051
PubMed Web of Science® Google Scholar
9Cvitkovic-Kuzmic A, Brkljacic B, Ivankovic D, Grga A. Ultrasound assessment of detrusor muscle thickness in children with non-neuropathic bladder/sphincter dysfunction. Eur Urol 2002; 41: 214–218.
10.1016/S0302-2838(01)00023-9
PubMed Web of Science® Google Scholar
10Tanaka H, Matsuda M, Moriya K, Mitsui T, Kitta T, Nonomura K. Ultrasonographic measurement of bladder wall thickness as a risk factor for upper urinary tract deterioration in children with myelodysplasia. J Urol 2008; 180: 312–316.
10.1016/j.juro.2008.03.062
PubMed Web of Science® Google Scholar
11Kojima M, Inui E, Ochiai A, Naya Y, Okimura O, Watanabe H. Ultrasonic estimation of bladder weight as a measure of bladder hypertrophy in men with infravesical obstruction: a preliminary report. Urology 1996; 47: 942–947.
10.1016/S0090-4295(96)00059-3
CAS PubMed Web of Science® Google Scholar
12Ukimura O, Kojima M, Inui E, Naya Y, Kawauchi A, Watanabe H. Noninvasive evaluation of bladder compliance in children using ultrasound estimated bladder weight. J Urol 1998; 160: 1459–1462.
10.1016/S0022-5347(01)62591-6
CAS PubMed Web of Science® Google Scholar
13Leung VY, Chu WC, Yeung CK. Nomograms of total renal volume, urinary bladder volume and bladder wall thickness index in 3,376 children with a normal urinary tract. Pediatr Radiol 2007; 37: 181–188.
10.1007/s00247-006-0376-y
PubMed Web of Science® Google Scholar
14Milo R, Jorgensen P, Springer, M. https://bionumbers.hms.harvard.edu/bionumber.aspx?id=109719&ver=2&trm=bladder&org
Google Scholar
15Fairhurst JJ, Rubin CM, Hyde I, Freeman NV, Williams JD, et al. Bladder capacity in infants. J Pediatr Surg 1991; 26: 55–57.
10.1016/0022-3468(91)90426-T
CAS PubMed Web of Science® Google Scholar
16Berger RM, Maizels M, Moran GC, Conway JJ, Firlit CF. Bladder capacity (ounces) equals age (years) plus 2 predicts normal bladder capacity and aids in diagnosis of abnormal voiding patterns. J Urol 1983; 129: 347–349.
10.1016/S0022-5347(17)52091-1
CAS PubMed Web of Science® Google Scholar
17Brkljacic B, Kuzmic AC, Dmitrovic R. Ultrasound-estimated bladder weight in healthy children. Eur Radiol 2004; 14: 1596–1599.
10.1007/s00330-004-2304-6
PubMed Web of Science® Google Scholar
18Kojima M, Inui E, Ochiai A, Naya Y, Ukimura O, Watanabe H. Noninvasive quantitative estimation of infravesical obstruction using ultrasonic measurement of bladder weight. J Urol 1997; 157: 476–479.
10.1016/S0022-5347(01)65178-4
CAS PubMed Web of Science® Google Scholar
19Ewalt DH, Howard PS, Blyth BB, et al. Is lamina propria matrix responsible for normal bladder compliance? J Urol 1992; 148: 544–549.
10.1016/S0022-5347(17)36650-8
CAS PubMed Web of Science® Google Scholar
20Muller L, Abrahamsson K, Sillen U, Jacobsson B, Odeon A, Hellstrom M. Ultrasound assessment of detrusor thickness in children and young adults with myelomeningocele. J Urol 2006; 175: 704–708.
10.1016/S0022-5347(05)00182-5
CAS PubMed Web of Science® Google Scholar
21Tangal S, Gokce MI, Ozayar A, et al. Evaluation of a new ultrasound measurement tool for the diagnosis of dysfunctional voiding in pediatric population: full/empty bladder wall thickness ratio. Urology 2014; 83: 1369–1372.
10.1016/j.urology.2013.12.036
PubMed Web of Science® Google Scholar
22Muller L, Jacobsson B, Marild S, Hellstrom M. Detrusor thickness in healthy children assessed by a standardized ultrasound method. J Urol 2001; 166: 2364–2367.
10.1016/S0022-5347(05)65590-5
CAS PubMed Web of Science® Google Scholar
23Oelke M. International Consultation on Incontinence-Research Society (ICI-RS) report on non-invasive urodynamics: the need of standardization of ultrasound bladder and detrusor wall thickness measurements to quantify bladder wall hypertrophy. Neurourol Urodyn 2010; 29: 634–639.
10.1002/nau.20834
CAS PubMed Web of Science® Google Scholar
24Sreedhar B, Yeung CK, Leung VY, Chu CW. Ultrasound bladder measurements in children with severe primary nocturnal enuresis: pretreatment and posttreatment evaluation and its correlation with treatment outcome. J Urol 2008; 179: 1568–1572.
10.1016/j.juro.2007.11.096
CAS PubMed Web of Science® Google Scholar
25Yeung CK, Sreedhar B, Leung VT, Metreweli C. Ultrasound bladder measurements in patients with primary nocturnal enuresis: a urodynamic and treatment outcome correlation. J Urol 2004; 171: 2589–2594.
10.1097/01.ju.0000112978.54300.03
CAS PubMed Web of Science® Google Scholar
26Borden TA, McGuire EJ, Woodside JR, et al. Urinary undiversion in patients with myelodysplasia and neurogenic bladder dysfunction. Report of a workshop. Urology 1981; 18: 223–228.
10.1016/0090-4295(81)90349-6
CAS PubMed Web of Science® Google Scholar
27Galloway NT, Mekras JA, Helms M, Webster GD. An objective score to predict upper tract deterioration in myelodysplasia. J Urol 1991; 145: 535–537.
10.1016/S0022-5347(17)38389-1
CAS PubMed Web of Science® Google Scholar
28Sturm RM, Yerkes EB, Nicholas JL, et al. Ultrasound shear wave elastography: a novel method to evaluate bladder pressure. J Urol 2017; 198: 422–429.
10.1016/j.juro.2017.03.127
PubMed Web of Science® Google Scholar
29Calle-Toro JS, Oterio H, Maya CL, Delgado J, Weiss DA, Long CJ, Zderic and D.K. SA, Back SJ, Ultrasound shear wave Elastography cannot discriminate between low and high-pressure neurogenic bladders. J Pediatr Urol 2022; 18:P326.E1–326.E8.
10.1016/j.jpurol.2022.03.016
PubMed Web of Science® Google Scholar
30Kuzmic AC, Brkljacic B, Ivankovic D. Sonographic measurement of detrusor muscle thickness in healthy children. Pediatr Nephrol 2001; 16: 1122–1125.
10.1007/s004670100042
CAS PubMed Web of Science® Google Scholar
31Chalana V, Dudycha S, Yuk JT, McMorrow G. Automatic measurement of ultrasound-estimated bladder weight (UEBW) from three-dimensional ultrasound. Rev Urol 2005; 7: S22–S28.
PubMed Google Scholar

Volume42, Issue1

January 2023

Pages 17-26

Ultrasound-Estimated Bladder Weight Correlates With Videourodynamic Studies in Neurogenic Bladder Dysfunction

Abstract

Purpose

Materials and Methods

Results

Conclusion

References

References

Information

About Wiley Online Library

Help & Support

Opportunities

Connect with Wiley

Ultrasound-Estimated Bladder Weight Correlates With Videourodynamic Studies in Neurogenic Bladder Dysfunction

Abstract

Purpose

Materials and Methods

Results

Conclusion

References

References

Related

Information