Ultrasound Shear Wave Elastography: A Novel Method to Evaluate Bladder Pressure

Yerkes, Elizabeth B.; Nicholas, Jennifer L.; Snow-Lisy, Devon C.; Saldano, Dawn Diaz; Gandor, P. Lacy; Halline, Christopher; Rosoklija, Ilina; Rychlik, Karen; Johnson, Emilie K.; Cheng, Earl Y.

doi:10.1016/j.juro.2017.03.127

Cited by 32 publications

(41 citation statements)

References 24 publications

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“…Approximately 15% of patients present abnormalities in image evaluation and UDS identifies DO in about 50% of patients in the first months of life . Cystometry should be carried out periodically and indefinitely, because bladder pressure values are critical in determining prognosis in neurogenic patients, as well as hydronephrosis pathogenesis, VUR presence and kidney failure development …”

Section: Discussionmentioning

confidence: 99%

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Can dynamic ultrasonography replace urodynamics in the follow‐up of patients with myelomeningocele? A prospective concurrent study

Bortolini

Lucena

Batezini

et al. 2018

Neurourology and Urodynamics

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Aims: To evaluate the accuracy of dynamic ultrasonography (DUS), as a feasible alternative diagnostic method to identify detrusor overactivity (DO) in patients with neurogenic bladder. Methods: We performed concurrent analysis of 81 pairs of urodynamic study (UDS) and DUS, in 63 patients with myelomeningocele (MMC), from June 2014 to February 2017. The assessment focused on bladder behavior during the filling phase, DO evaluation, DO with leakage, compliance, and maximum cystometric capacity (MCC). Results: Patient age ranged from 3 months to 34 years (median, 84 months); 47.6% were male. Overall, 9.5% of patients had chronic kidney disease, 20.6% had recurrent urinary tract infection, 19.05% had vesicoureteral reflux, and 69.8% had constipation. Anticholinergic therapy was used by 41.3% of patients. DO was observed in 45.67% of patients and DO with leakage in 42.6%. Mean bladder compliance was 10.39 mL/ cmH 2 O and normal MCC was 56.79%. DUS had 91.89% sensitivity in identifying DO, 88.64% specificity, 87.18% positive predictive value, 92.86% negative predictive value, and 90.12% accuracy, with a kappa coefficient of 0.8 (P < 0.001). Conclusion: MMC follow-up is essential because urinary parameters can change during patient growth. The standard examination is invasive and has related complications, making noninvasive evaluation a desirable alternative, like DUS. Our data suggest that DO and MCC can be evaluated using DUS in patients with MMC. UDS should be performed in patients with abnormal findings on ultrasound evaluation or those with worsening of urinary tract function. K E Y W O R D S dynamic ultrasonography, myelomeningocele, pediatric neurogenic bladder, spinal dysraphism

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Section: Discussionmentioning

confidence: 99%

“…As a predictive tool to identify bladder wall abnormalities, ultrasonography requires a skilled and dedicated professional. Complementary techniques, such as elastography and bladder vibrometry, are being evaluated to optimize this predictive potential of this testing.…”

Section: Discussionmentioning

confidence: 99%

Can dynamic ultrasonography replace urodynamics in the follow‐up of patients with myelomeningocele? A prospective concurrent study

Bortolini

Lucena

Batezini

et al. 2018

Neurourology and Urodynamics

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“…Fatemi et al 21 developed a bladder vibrometry method in which ultrasonic shear waves were used to measure wall elasticity. Likewise, Sturm et al 22 were able to achieve similar results using bladder elastography. In addition, Nagle et al 23 have developed a method to calculate real-time detrusor wall tension during UD filling using ultrasound-derived metrics.…”

Section: Discussionmentioning

confidence: 78%

Comparative‐fill urodynamics in individuals with and without detrusor overactivity supports a conceptual model for dynamic elasticity regulation

Cullingsworth

Klausner

et al. 2019

Neurourology and Urodynamics

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Aims: Dynamic elasticity was previously identified in individuals with overactive bladder (OAB) using comparative-fill urodynamics (UD) and is a biomechanical mechanism for acutely regulating detrusor wall tension. On the basis of this data, a conceptual model of dynamic elasticity regulation mediated through a balance of passive mechanisms and active contractions was constructed. The present study tested this model by determining whether individuals with detrusor overactivity (DO) exhibit less dynamic elasticity than individuals without DO. Methods: Individuals with and without urgency based on InternationalConsultation on Incontinence Questionnaire-OAB surveys were prospectively enrolled in a comparative-fill UD study. An initial fill defined the presence or absence of DO and determined cystometric capacity. Three additional fills were employed with either passive emptying via a catheter or active voiding. To identify dynamic elasticity, average filling pressures (P ves ) were compared for fill 1 (before strain softening), fill 2 (after strain softening), and fill 3 (after active void). A dynamic elasticity index was defined.Results: From 28 participants, those without DO showed decreased P ves during filling after strain softening and restored P ves during filling following active voiding, revealing dynamic elasticity. Participants with DO did not show dynamic elasticity.A dynamic elasticity index less than 1.0 cmH 2 O/40% capacity was identified in 2 out of 13 participants without DO and 9 out of 15 with DO, revealing a significant association between DO and reduced/absent dynamic elasticity (P = .024).Conclusions: This study supports a conceptual model for dynamic elasticity, a mechanism to acutely regulate detrusor wall tension through a balance of competing active contractile and passive strain mechanisms. Improved understanding of this mechanistic model may help us to identify novel treatment strategies for OAB. K E Y W O R D Sbladder biomechanics, bladder compliance, cystometry, overactive bladder

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“…As the connective tissue to smooth muscle ratio increases the rigidity of the bladder increases and capability to expand during filling decreases which in turn reduces the bladder capacity (21). Bladder measurements by ultrasound shear wave elastography are in correlation with bladder storage pressure and measurements of shear wave speed differentiate between compliant and noncompliant bladders (22). Urodynamic pressure-flow study, which can differentiate BOO from detrusor underactivity is the most dependable diagnostic standard for BOO.…”

Section: Discussionmentioning

confidence: 99%

Could Bladder wall elastography be used as an indicator for the diagnosys of bladder outlet obstruction by Benign Prostate Hyperplasia?

Eryılmaz¹,

Aslan²,

Arslan³

et al. 2020

Eastern J Med

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Benign prostatic hyperplasia (BPH) is one of the most common causes of bladder outlet obstruction in me n. In this study we aimed to evaluate the elasticity of the bladder by Acoustic Radiation Force Impulse (ARFI) elastography in BPH patients. Fifty benign prostate patients were included in the study. After evaluation of patients in the outpatient clinic. A RFI elastography was performed with full bladder. Elastography was performed separately on the anterior, right and left walls of the bladder. Then the patient underwent uroflowmetry. The maximum flow rate and post-mix residual values in uroflowmetry were recorded. The mean age of the patients was 45.6 ± 3.77 The average of bladder anterior wall elasticity 3.39 ± 0.89, Bladder left wall elasticity 2,69 ± 0,82 and Bladder right wall elasticity was 3.69 ± 0.89.The mean prostate size 52.58 ± 24.16 The average of Qmax11.96 ± 4.85 The mean of PMR 77.8 ± 59.6 and mean of prostate elasticity was 2.97 ± 1.1 Urinary bladder wall elasticity with ARFI can be a diagnostic indicator for bladder outlet obstruction due to BPH.

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Ultrasound Shear Wave Elastography: A Novel Method to Evaluate Bladder Pressure

Cited by 32 publications

References 24 publications

Can dynamic ultrasonography replace urodynamics in the follow‐up of patients with myelomeningocele? A prospective concurrent study

Can dynamic ultrasonography replace urodynamics in the follow‐up of patients with myelomeningocele? A prospective concurrent study

Comparative‐fill urodynamics in individuals with and without detrusor overactivity supports a conceptual model for dynamic elasticity regulation

Could Bladder wall elastography be used as an indicator for the diagnosys of bladder outlet obstruction by Benign Prostate Hyperplasia?

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