Bladder compliance what does it represent: Can we measure it, and is it clinically relevant?

Abstract

Methods: During a three day meeting a group of specialists discussed compliance, what it represents, how it can be measured and if it is clinically relevant.Results: Bladder compliance is the result of a mathematical calculation of volume responsible for 1 cm H2O pressure rise measured during a cystometric filling. It gives an indication on how the different mechanisms in the bladder wall react on stretching. There is a need of standardisation of measurement and suggestions for this are given in the text. Pitfalls are described and how to avoid them. There is a wide range of compliance values in healthy volunteers and groups of patients. Poor compliance needs to be defined better as it can have significant clinical consequences. Prevention and treatment are discussed.Conclusion: If compliance is correctly measured and interpreted, it has importance in urodynamic testing and gives information relevant for clinical management.

Urodynamic findings, bladder emptying methods and therapeutic approaches in patients with upper lumbar and lower lumbar–sacral spinal cord injury

“…Compliance is calculated by dividing the volume change (DV) by the change in detrusor pressure (Dp det ) (C = DV/Dp det , expressed in ml/cmH 2 O) [14]. Two standard points should be used: the start of filling and cystometric capacity or immediately before any detrusor contractions that will end the test by, for example, significant leakage [15]. The compliance was accepted as normal (detrusor pressure C20 ml/cmH 2 O) or hypocompliance (detrusor pressure \20 ml/cmH 2 O) [1].…”

“…The compliance was accepted as normal (detrusor pressure C20 ml/cmH 2 O) or hypocompliance (detrusor pressure \20 ml/cmH 2 O) [1]. Detrusor overactivity, low bladder capacity, vesicoureteric reflux, high bladder weight, recent retention episodes, low bladder wall blood flow, and usage of indwelling catheters are associated with poor bladder compliance [15]. As the detrusor overactivity is more frequent in the ULSCI group, the rate of detrusor hypocompliancy was found to be higher in this group.…”

Neurogenic detrusor overactivity in adults: a review on efficacy, tolerability and safety of oral antimuscarinics

“…Moreover, the nonexistence of placebo effects in NDO studies may counteract the limited patient numbers. [13][14][15] The evaluation of the studies revealed some deficits, as clinically important parameters were either not evaluated or not reported: the impact of AM on bladder compliance, which was either not assessed or the results given were difficult to interpret due to nonuniform methodology; 42 the issue, whether AM shorten a prolonged detrusor contraction, the need for IC, exact data on the achievement of continence, for example, in-between IC, the impact of AM on UTI frequency and on QoL. This deficiency with respect to QoL may be because of the fact that many studies were conducted at a time when this issue was not yet a primary research focus.…”

Evaluación y tratamiento del niño con síntomas del tracto urinario inferior (LUTS)

“…En la cistometría se monitorizan los cambios de presión vesical durante la fase de llenado y se evalúan la sensibilidad, la capacidad, la acomodación vesical, la actividad del detrusor y la función uretral durante dicha fase. En el estudio presión-volumen se evalúan la actividad del detrusor y la función uretral durante la fase de vaciamiento (13,14). No todo paciente con LUTS requiere un estudio urodinámico completo.…”