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Noninvasive evaluation of bladder compliance in children using ultrasound estimated bladder weight
1Department of Urology, Kyoto Prefectural University of Medicine, Japan.
Insights
Ultrasound estimated bladder weight can accurately predict bladder compliance in children. This noninvasive method helps identify potential urodynamic abnormalities in pediatric patients.
Area of Science:
- Pediatric Urology
- Medical Imaging
- Urodynamics
Background:
- Bladder compliance is a crucial parameter in assessing lower urinary tract function in children.
- Traditional urodynamic methods like cystometry can be invasive and challenging in pediatric populations.
- There is a need for noninvasive, reliable methods to evaluate bladder compliance in children.
Purpose of the Study:
- To determine the utility of ultrasound-estimated bladder weight (UEBW) as a measure of bladder compliance in children.
- To establish reference values for UEBW in healthy children.
- To correlate UEBW with bladder compliance in children with urinary disturbances.
Main Methods:
- Measured UEBW in 71 healthy children to establish standard values.
- Assessed UEBW in 82 children with urinary disturbances, alongside conventional urological examinations including filling cystometry.
- Calculated the percent deviation of UEBW from age-matched standards and correlated it with bladder compliance.
Main Results:
- UEBW showed a significant linear correlation with age in healthy children (r = 0.80).
- A cutoff deviation of 100% in UEBW accurately predicted low bladder compliance (less than 10 ml/cm water) with 96.3% diagnostic accuracy.
- Children with UEBW within 100% deviation predominantly had normal bladder compliance (≥ 10 ml/cm water).
Conclusions:
- Ultrasound-estimated bladder weight is a valuable noninvasive tool for evaluating bladder compliance in children.
- UEBW can serve as a suitable noninvasive urodynamic test for pediatric patients with suspected bladder abnormalities.
- This method offers a promising alternative to invasive urodynamic testing for assessing bladder function in children.
Purpose:
In healthy children as well as those with urinary disturbance we determined ultrasound estimated bladder weight with the aim of revealing its possible usefulness as a measure of bladder compliance.
Materials And Methods:
We measured ultrasound estimated bladder weight in 71 healthy children with a mean age of 10.3 years, and determined a standard value. A total of 82 patients with a mean age of 9.6 years with urinary disturbance also underwent ultrasound estimated bladder weight measurement as well as conventional urological examinations, including filling cystometry.
Results:
In healthy children ultrasound estimated bladder weight increased with age, showing a significant linear correlation (r = 0.80, p < 0.0001). Using the formula for linear correlation, 0.86 x patient age + 6.9 gm., we obtained an age matched estimated weight. In 82 patients the percent deviation of the estimate from age matched values was calculated using the formula, (measured ultrasound estimated bladder weight -age matched ultrasound estimated bladder weight)/age matched ultrasound estimated bladder weight x 100, and then correlated with bladder compliance. In 75 of 77 patients (97%) with compliance of 10 ml./cm. water or more the estimate was within 100% deviation. In contrast, 4 of 5 patients (80%) with a low compliant bladder (less than 10 ml./cm. water) had an ultrasound estimated bladder weight greater than 100% deviation. When the estimate was within 100% deviation, all but 1 patient (75 of 76, 98.7%) had compliance of 10 ml./cm. water or more compared to 33.3% (2 of 6) of those with an estimate greater than 100% deviation. As a result, with the use of a cutoff value of 100% deviation ultrasound estimated bladder weight predicted a low compliant bladder with a diagnostic accuracy as high as 96.3% (79 of 82 cases).
Conclusions:
Ultrasound estimated bladder weight may be used to evaluate bladder compliance in children. It seems to be a suitable noninvasive urodynamic test in children with suspected urodynamic abnormalities.