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Ultrasonographic evaluation of bladder volume in young children
M Hiraoka1, C Hori, S Tsuchida
1Department of Paediatrics, Fukui Medical School, Japan.
Insights
Infants have a distinct bladder shape compared to older children. A new regression equation, specific to infants, significantly improves bladder volume estimation accuracy using ultrasonography measurements.
Area of Science:
- Pediatric Urology
- Medical Imaging
- Biostatistics
Background:
- Accurate bladder volume estimation is crucial for pediatric urological assessments.
- Previous bladder volume estimation formulas were developed for older children.
- Infant bladder morphology may differ significantly from that of older children.
Purpose of the Study:
- To investigate the bladder shape and dimensions in young children before voiding cystourethrography.
- To develop and validate a specific formula for estimating bladder volume in infants using ultrasonography.
- To compare the accuracy of infant-specific formula against a formula derived for older children.
Main Methods:
- Ultrasonography was used to measure anterior/posterior (D), superior/inferior (H), and transverse (W) bladder dimensions in 30 young children (26 boys, 4 girls) without established bladder control.
- A regression equation (Eq. 1: y = 0.49x + 3) was derived to estimate bladder volume (x) from D x H x W measurements.
- The accuracy of Eq. 1 was compared to a previously established formula (Eq. 2: y = 0.68x + 4) for older children.
Main Results:
- Young children exhibited a significantly greater H dimension relative to D and W compared to older children.
- The infant-specific regression equation (Eq. 1) resulted in a substantially lower mean percentage error (16.8% ± 10.7%) compared to the formula for older children (44.7% ± 26.2%).
- The difference in error rates was statistically significant (P < 0.01).
Conclusions:
- Infants possess a unique bladder shape distinct from older children.
- A specific formula derived from ultrasonography measurements is necessary for accurate bladder volume estimation in infants.
- Utilizing an infant-specific formula improves diagnostic accuracy in pediatric urology.
Abstract:
We investigated by ultrasonography the bladders of 30 young children (26 boys, 4 girls) without established bladder control immediately before voiding cystourethrography. The anterior/posterior (D), superior/inferior (H) and transverse dimension (W) of the bladder were determined. The small children had a significantly greater H value compared with D and W than older children in our previous study in 1993. The regression equation for D x H x W and actual bladder volume in 30 infants was calculated as y = 0.49 x + 3 (Eq. 1). When bladder volume of the 30 infants was estimated from D x H x W, the mean percentage error was much lower with Eq. 1 than with Eq. 2 (y = 0.68 x + 4), which had been determined for older children (mean +/- SD 16.8% +/- 10.7% vs. 44.7% +/- 26.2%) (P < 0.01). Thus, infants have a different bladder shape than older children and their bladder volume should be estimated using a specific formula designed for them.