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Detrusor pressure rise in a normal bladder.

Edward F Wahl¹, Bernard M Churchill

¹Clark-Morrison Children's Urological Center, UCLA School of Medicine, Los Angeles, CA, USA. edwahl@alum.mit.edu

BJU International

|October 13, 2004

Summary

The normal bladder detrusor pressure rise at capacity (P(cap,NL)) is approximately 6 cmH2O at maximum physiological diuresis. This value remains consistent across various infusion rates up to 35 mL/min.

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Area of Science:

Urology
Physiology

Background:

Determining normal bladder function is crucial for diagnosing lower urinary tract symptoms.
The detrusor pressure rise at bladder capacity (P(cap,NL)) is a key urodynamic parameter.
Existing data on P(cap,NL) requires further validation under standardized conditions.

Purpose of the Study:

To establish the detrusor pressure rise of a normal bladder (P(cap,NL)) at its maximal capacity.
To compare calculated P(cap,NL) values with existing published data.

Main Methods:

Selected 24 patients with apparently normal bladders from 218 clinical cystometrograms (CMGs).
Fitted a straight line to the pressure-volume (PV) plot of CMGs to calculate P(cap,NL).
Evaluated and compared obtained P(cap,NL) values with published data.

Main Results:

The mean P(cap,NL) for normal bladders at maximum physiological diuresis (MPD) was 6 cmH2O (range: 4.5-7 cmH2O).
P(cap,NL) was 6 cmH2O at 10% glomerular filtration rate (GFR) infusion rates.
P(cap,NL) ranged from 6-15 cmH2O for infusion rates up to 35 mL/min (3-10 times 10% GFR).

Conclusions:

Normal bladder P(cap,NL) is independent of patient age, size, and sex.
At constant infusion rates approximating MPD, P(cap,NL) is consistently 6 cmH2O.
P(cap,NL) ranges from 6-15 cmH2O for infusion rates up to 35 mL/min, providing a reliable clinical reference.

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