Bladder deformities in patients with neurogenic bladder dysfunction

Area of Science:

• Urology
• Nephrology
• Radiology

Background:

• Neurogenic bladder dysfunction affects bladder shape and compliance.
• Bladder deformities, such as trabeculation and altered shape, are common.
• Upper urinary tract deterioration is a serious complication.

Purpose of the Study:

• To evaluate the relationship between bladder deformities and upper urinary tract deterioration.
• To assess the prevalence of different grades of bladder deformity.
• To identify risk factors for high-grade bladder deformities.

Main Methods:

• Radiographic assessment of bladder deformity at maximum cystometric capacity in 231 patients.
• Classification of bladder deformity into four grades (0-III).
• Correlation analysis between bladder deformity grade and upper urinary tract deterioration (hydronephrosis/reflux).

Main Results:

• Upper urinary tract deterioration increased significantly with higher grades of bladder deformity (Grade 0: 2%, Grade I: 8%, Grade II: 52%, Grade III: 62%).
• High-grade deformities were more frequent in traumatic spinal cord injury and spinal dysraphism compared to brain diseases.
• Low bladder compliance was strongly associated with high-grade bladder deformities.

Conclusions:

• Bladder deformity is a significant risk factor for upper urinary tract deterioration in neurogenic bladder dysfunction.
• Prompt management, including clean intermittent catheterization, is crucial for preventing bladder deformities and subsequent complications.