Detrusor overactivity assessment using ultrasound bladder vibrometry

Abstract

Objective. Detrusor overactivity (DO) is a urodynamic observation characterized by fluctuations in detrusor pressure (P det) of the bladder. Although detecting DO is important for the management of bladder symptoms, the invasive nature of urodynamic studies (UDS) makes it a source of discomfort and morbidity for patients. Ultrasound bladder vibrometry (UBV) could provide a direct and noninvasive means of detecting DO, due to its sensitivity to changes in elasticity and load in the bladder wall. In this study, we investigated the feasibility and applying UBV toward detecting DO. Approach. UBV and urodynamic study (UDS) measurements were collected in 76 neurogenic bladder patients (23 with DO). Timestamped group velocity squared ( c g 2 ) data series were collected from UBV measurements. Concurrent P det data series were identically analyzed for comparison and validation. A processing approach is developed to separate transient fluctuations in the data series from the larger trend of the data and a DO index is proposed for characterizing the transient peaks observed in the data. Main Results. Applying the DO index as a classifier for DO produced sensitivities and specificities of 0.70 and 0.75 for c g 2 data series and 0.70 and 0.83 for P det data series respectively. Significance. It was found that DO can be feasibly detected from data series of timestamped UBV measurements. Collectively, these initial results are promising, and further refinement to the UBV measurement process is likely to improve and clarify its capabilities for noninvasive detection of DO.

Lower Urinary Tract Symptoms in Depression: A Review

“…38 Detrusor overactivity refers to a urodynamic observation characterized by uncontrolled detrusor contractions during the filling phase. 39,40 Detrusor overactivity can be categorized based on the identified etiology, namely idiopathic or neurogenic, and the type of contraction, namely terminal or phasic. 39 Although phasic contractions may or may not result in urinary incontinence, terminal contractions often lead to complete emptying of the bladder.…”

“…50% of men over 50 will experience some form of LUTS including sometimes overlooked conditions such as BPH. 40 It is further estimated by the UN and speculated on by Nishii H. that 80% of the aging population will be in underdeveloped areas. 40,41 This is troubling for several reasons: 1) Mental health is widely underserved around the world, even in developed countries.…”

“…40 It is further estimated by the UN and speculated on by Nishii H. that 80% of the aging population will be in underdeveloped areas. 40,41 This is troubling for several reasons: 1) Mental health is widely underserved around the world, even in developed countries. [42][43][44] 2) Around 33% of people by age 50 will develop some form of LUTS with it becoming essentially a matter of fact for men as they continue to age.…”

“…[42][43][44] 2) Around 33% of people by age 50 will develop some form of LUTS with it becoming essentially a matter of fact for men as they continue to age. 40, 3) There is a known association between depression and LUTS. 40,47,48,[50][51][52][54][55][56][57][58][59][60][61][62] The question we seek to answer is can depression actually cause LUTS?…”

“…40, 3) There is a known association between depression and LUTS. 40,47,48,[50][51][52][54][55][56][57][58][59][60][61][62] The question we seek to answer is can depression actually cause LUTS? LUTS are present in at least 40% of men for extended periods of time which lead to significant impacts on HRQL.…”