MP18-01: Increased Provoked Bladder Compliance Associated with High Urgency Bother in a Subset of Women ≥50 Years Old Using Ultrasound Urodynamics
Friday, May 3, 2024 3:30 PM to 5:30 PM · 2 hr. (US/Central)
302B
Abstract
Information
Full Abstract and Figures
Author Block
Michael Shields, Isabelle Pummill, Adam Vossenberg, Margaret Lefebvre*, Christopher Keshishian, Julia Smolen, Sarah Kodama, Ria Khandpur, Jared Dunlap, Mina Ghatas, Linda Burkett, Lauren Siff, Ashley Carroll, Adam P Klausner, John E Speich, Richmond, VA
Introduction
Lower urinary tract symptoms can be caused by altered bladder compliance, which is calculated during urodynamics testing (UDT) as ?volume/?pressure. A novel “provoked compliance” calculation may be used to assess the bladder’s response to compression. The objective of this study was to quantify provoked compliance in response to bladder compressions using ultrasound (US) – UDT.
Methods
Adult patients undergoing clinically indicated UDT were enrolled. Standard compliance (?V/?P), demographics, and ICIq-OAB surveys were recorded. Provoked compliance testing was initiated by pausing the pump at 50% capacity (based on 3-day void diary). A transverse US image was captured, serving as a baseline. The bladder was then compressed by the US probe to roughly half of the baseline anterior-posterior diameter for 5 seconds followed by a 5 second pause. This process was repeated 5x with transverse US images being captured during each compression and pause. ImageJ circularity function was utilized to calculate circularity by manually tracing the bladder wall in each captured image. Provoked compliance (?circularity/?pressure) was then calculated by averaging circularity and pressure data across points of max compression.
Results
In data analyzed from 44 participants, there was significant association between age and increased provoked compliance, particularly with patients =50 years old compared to younger patients (p<0.05). Provoked compliance was >0.0275 cm-H2O-1 in 10/22 (45.5%) participants =50 years old compared to 0/12 (0%) in patients <50 years old (Fig 1A). Additionally, increased bother score (=9) was associated with a higher likelihood of having a high provoked compliance (>0.0275 cm-H2O-1) compared to bother scores <9 (<0.0275 cm-H2O-1, p<0.05) (Fig 1B). There was no association between low filling compliance (<30 ml/cmH20) and provoked compliance (p>0.05).
Conclusions
Higher provoked compliance (floppier bladders) during bladder compressions was seen in patients =50 years old and those with increased bothersome urgency. Additional investigation is required to determine association with OAB and other forms of voiding dysfunction.
Source Of Funding
NIH R01DK101719, NSF REU 1852116, VCU School of Medicine Summer Research Fellowship
Author Block
Michael Shields, Isabelle Pummill, Adam Vossenberg, Margaret Lefebvre*, Christopher Keshishian, Julia Smolen, Sarah Kodama, Ria Khandpur, Jared Dunlap, Mina Ghatas, Linda Burkett, Lauren Siff, Ashley Carroll, Adam P Klausner, John E Speich, Richmond, VA
Introduction
Lower urinary tract symptoms can be caused by altered bladder compliance, which is calculated during urodynamics testing (UDT) as ?volume/?pressure. A novel “provoked compliance” calculation may be used to assess the bladder’s response to compression. The objective of this study was to quantify provoked compliance in response to bladder compressions using ultrasound (US) – UDT.
Methods
Adult patients undergoing clinically indicated UDT were enrolled. Standard compliance (?V/?P), demographics, and ICIq-OAB surveys were recorded. Provoked compliance testing was initiated by pausing the pump at 50% capacity (based on 3-day void diary). A transverse US image was captured, serving as a baseline. The bladder was then compressed by the US probe to roughly half of the baseline anterior-posterior diameter for 5 seconds followed by a 5 second pause. This process was repeated 5x with transverse US images being captured during each compression and pause. ImageJ circularity function was utilized to calculate circularity by manually tracing the bladder wall in each captured image. Provoked compliance (?circularity/?pressure) was then calculated by averaging circularity and pressure data across points of max compression.
Results
In data analyzed from 44 participants, there was significant association between age and increased provoked compliance, particularly with patients =50 years old compared to younger patients (p<0.05). Provoked compliance was >0.0275 cm-H2O-1 in 10/22 (45.5%) participants =50 years old compared to 0/12 (0%) in patients <50 years old (Fig 1A). Additionally, increased bother score (=9) was associated with a higher likelihood of having a high provoked compliance (>0.0275 cm-H2O-1) compared to bother scores <9 (<0.0275 cm-H2O-1, p<0.05) (Fig 1B). There was no association between low filling compliance (<30 ml/cmH20) and provoked compliance (p>0.05).
Conclusions
Higher provoked compliance (floppier bladders) during bladder compressions was seen in patients =50 years old and those with increased bothersome urgency. Additional investigation is required to determine association with OAB and other forms of voiding dysfunction.
Source Of Funding
NIH R01DK101719, NSF REU 1852116, VCU School of Medicine Summer Research Fellowship
Sessions
MP18: Imaging/Uroradiology I
302B