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Detrusor biopsy as a potential clinical tool
M A Mastropietro1, W Geary, E Fuller
1Indiana University/Methodist Hospital, Indianapolis 46202, USA.
International Urogynecology Journal and Pelvic Floor Dysfunction
|January 25, 2002
Summary
Detrusor biopsy electron microscopy findings showed poor agreement with urodynamic diagnoses in urogynecology patients. This suggests bladder dysfunction etiology requires broader investigation beyond structural changes.
Area of Science:
- Urology
- Pathology
- Geriatric Medicine
Background:
- Previous studies indicated a correlation between electron microscopy of bladder biopsies and urodynamic diagnoses in older adults.
- The clinical utility of detrusor biopsy for diagnosing and managing bladder dysfunction in urogynecology patients requires further evaluation.
Purpose of the Study:
- To assess the reproducibility of prior findings linking bladder biopsy microscopy to urodynamic diagnoses.
- To determine if detrusor biopsy is a viable clinical tool for urogynecology patients.
Main Methods:
- Twenty-six women underwent comprehensive urodynamic evaluations and cystoscopic-guided detrusor muscle biopsies.
- Urodynamic and electron microscopy pathology diagnoses were assigned in a double-blind manner.
- Agreement between urodynamic and pathologic diagnoses was calculated.
Main Results:
- Overall agreement between urodynamic and pathologic diagnoses was low at 30%.
- Specific agreements included detrusor overactivity/dysjunction (52%), obstructed voiding/hypertrophy (78%), and ineffective contractility/degeneration (65%).
- The study did not support detrusor biopsy as a clinical tool due to low diagnostic agreement.
Conclusions:
- Detrusor biopsy electron microscopy findings do not reliably correlate with urodynamic diagnoses in this urogynecology population.
- Investigating the causes of bladder dysfunction should extend beyond examining organ-specific structural changes.