Phasic Changes in Bladder Compliance During Filling Cystometry of the Neurogenic Bladder

Annals of Rehabilitation Medicine, 2014 · DOI: http://dx.doi.org/10.5535/arm.2014.38.3.342 · Published: May 1, 2014

Spinal Cord Injury Urology Rehabilitation

Simple Explanation

This study investigates how bladder behavior changes during a test called filling cystometry, which is used to assess bladder function, especially in people with neurogenic bladders (bladders affected by nerve damage). The goal was to identify which part of the filling process best reflects the overall condition of the bladder. The researchers divided the bladder filling process into three phases and measured bladder compliance (how much the bladder stretches in response to pressure) in each phase. They then compared these phase-specific measurements to the overall bladder compliance to see which phase was most representative. The study found that bladder compliance during the early filling phase was the most indicative of overall bladder compliance. This suggests that focusing on the early phase of filling cystometry can provide the most reliable information about bladder function in individuals with neurogenic bladders.

Study Duration

Not specified

Participants

78 patients (59 males, 19 females) with spinal cord injuries

Evidence Level

Not specified

Key Findings

1
Bladder compliance during the first and second phases of filling cystometry was significantly correlated with overall bladder compliance in overactive detrusors.
2
The highest coefficient of determination (r2=0.329) was obtained during the first phase of the pressure-volume curve in overactive detrusors.
3
Bladder compliance during all three phases was significantly correlated with overall bladder compliance of filling cystometry in underactive detrusors, with the greatest coefficient during the first phase (r2=0.529).

Research Summary

This study aimed to determine which phase of filling cystometry best represents detrusor properties in neurogenic bladders, independent of factors affecting detrusor contractility. Seventy-eight patients with spinal cord injuries were enrolled, and bladder compliance was calculated for each of three filling phases. The results indicated that phasic bladder compliance during the early filling phase (first filling phase) was the most representative assessment of overall bladder compliance during filling cystometry, regardless of detrusor activity. The study concludes that careful determination of early phase filling is important when seeking to acquire reliable urodynamic data on neurogenic bladders.

Practical Implications

Improved Urodynamic Assessments

Focusing on the early filling phase during cystometry can lead to more accurate assessments of bladder function in patients with neurogenic bladders.

Targeted Interventions

Understanding the early phase bladder compliance can help in developing targeted interventions to improve bladder function.

Enhanced Patient Care

Reliable urodynamic data can aid in better management and care of patients with neurogenic bladder, improving their quality of life.

Study Limitations

1
Patients with a spinal cord injury and who were taking medication (anticholinergics or cholinergics) were included.
2
The drug effect could have influenced the parameters of the urodynamic study.
3
Constant bladder filling rates of 24 mL/min in the urodynamic study likely underestimated true compliance in overactive detrusors and overestimated true compliance in underactive or acontractile detrusors.

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