Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Mar;26(1):52-59.
doi: 10.5213/inj.2142244.122. Epub 2022 Mar 31.

A Study of Urodynamic Parameters at Different Bladder Filling Stages for Predicting Upper Urinary Tract Dilatation

Lei Lyu  1 , Ya Xiong Yao  2 , Er Peng Liu  1 , Yan Ping Zhang  1 , Hui Jie Hu  3 , Feng Ping Ji  1 , Qing Song Pu  1 , Xing Huan Yang  1 , Qing Wei Wang  1 , Yan Wang  1 , Jian Guo Wen  1
Affiliations

A Study of Urodynamic Parameters at Different Bladder Filling Stages for Predicting Upper Urinary Tract Dilatation

Lei Lyu et al. Int Neurourol J. 2022 Mar.

Abstract

Purpose: To identify more accurate predictors of upper urinary tract dilatation (UUTD) in neurogenic bladder (NB) children, we studied the relationship among urodynamic parameters at different bladder filling stages, detrusor leak point pressure (DLPP) and UUTD.

Methods: A total of 158 children (3-16 years) with NB were included and then divided into 2 groups according to whether their NB diagnosis was complicated with UUTD: the UUTD group (39 patients) and those without UUTD group (control group, 119 patients). The bladder filling phase was divided into 3 equal parts: the early, middle, and end filling stages. The bladder compliance (BC) and detrusor pressure (△Pdet) at each phase and DLPP at the end filling stage were recorded.

Results: A BC<8 mL/cm H2O both in the middle and end stages is more specific than a BC<9 mL/cm H2O in the end stage (72%, 73%, vs. 66%), and △Pdet >8 cm H2O in the early stage, 20 cm H2O in the middle stage and 25 cm H2O in the end stage are more sensitive than △Pdet >40 cm H2O in the end stage (82%, 85%, 85%, vs. 49%). A DLPP cutoff value of 20 cm H2O showed higher sensitivity for predicting UUTD than 40 cm H2O.

Conclusion: Low BC and a high △Pdet in the middle and end filling stages are more accurate factors than classic indicators for predicting UUTD. In addition, a DLPP value of >20 cm H2O in the end bladder filling stage shows high sensitivity.

Keywords: Child; Detrusor leak point pressure; Detrusor pressure; Upper urinary tract dilatation; ladder compliance.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
A female with upper urinary tract dilatation, 14 years old, 7 years after spinal cord trauma operation. Bladder compliance decreased significantly (bladder compliance <5 mL/cm H2O). In the middle filling stage, the detrusor pressure increased quickly (red arrow) and then slowly
Fig. 2.
Fig. 2.
Receiver operating characteristic curve of bladder compliance (BC) in different filling stages predicting upper urinary tract dilatation. The cutoff value of BC2 is 8.21 (AUC=0.797). The cutoff value of BC3 is 8.24 (AUC=0.785). AUC, area under the curve.
Fig. 3.
Fig. 3.
Receiver operating characteristic curve of △Pdet in different filling stages predicting upper urinary tract dilatation. The cutoff value of Pdet1 is 7.7 (AUC=0.810). The cutoff value of △Pdet2 is 19.5 (AUC=0.845). The cutoff value of △Pdet3 is 24.5 (AUC=0.816). △Pdet, detrusor pressure; AUC, area under the curve.
Fig. 4.
Fig. 4.
Receiver operating characteristic curve of the detrusor leak point pressure (DLPP) in all patients predicting upper urinary tract dilatation. The cutoff value of DLPP is 19.5 (AUC=0.657). AUC, area under the curve.
See this image and copyright information in PMC

References

    1. McGuire EJ, Woodside JR, Borden TA. Upper urinary tract deterioration in patients with myelodysplasia and detrusor hypertonia: a followup study. J Urol. 1983;129:823–6. - PubMed
    1. Wang W, Fang H, Xie P, Cao Q, He L, Cai W. Create a predictive model for neurogenic bladder patients: upper urinary tract damage predictive nomogram. Int J Neurosci. 2019;129:1240–6. - PubMed
    1. Wang QW, Wen JG, Song DK, Su J, Che YY, Zhang P, et al. Is it possible to use urodynamic variables to predict upper urinary tract dilatation in children with neurogenic bladder-sphincter dysfunction? BJU Int. 2006;98:1295–300. - PubMed
    1. Kurzrock EA, Polse S. Renal deterioration in myelodysplastic children: urodynamic evaluation and clinical correlates. J Urol. 1998;159:1657–61. - PubMed
    1. Ghoniem GM, Roach MB, Lewis VH, Harmon EP. The value of leak pressure and bladder compliance in the urodynamic evaluation of meningomyelocele patients. J Urol. 1990;144:1440–2. - PubMed

LinkOut - more resources