Quantification of bladder wall biomechanics during urodynamics: A methodologic investigation using ultrasound

Nagle, Anna S.; Klausner, Adam P.; Varghese, Jary; Bernardo, Rachel; Colhoun, Andrew; Barbee, R. Wayne; Carucci, Laura R.; Speich, John E.

doi:10.1016/j.jbiomech.2017.07.028

Cited by 24 publications

(29 citation statements)

References 29 publications

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“…The elastic modulus itself is a positive function of strain, when these strains are over ranges near to and above the resting length of the tissue 12 ; these experiments used smaller proportional strain changes (20% of resting length) which reflect changes in the intact bladder during filling. 13 A striking feature of the data is the wide range of elastic modulus values in the cohort of young animals, similar to that observed in aged animals.…”

Section: Discussionsupporting

confidence: 65%

Stretch‐ and carbachol‐induced ATP release from bladder wall preparations of young and aged mice

Nishikawa

Chakrabarty

Kitney

et al. 2020

Neurourology and Urodynamics

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Aims Bladder wall stretch increases tissue tension and releases adenosine 5'‐triphosphate (ATP) as part of a transduction process to sense bladder filling. Aging is associated with bladder fibrosis to produce a stiffer bladder wall: this may augment ATP release and contribute to age‐dependent urgency. Muscarinic agonists also release ATP and present a potential target for antimuscarinic agents, but its age‐dependency is unknown. This study aimed, in young and old mice, to: (a) quantify the relationship between bladder wall stiffness and stretch‐dependent ATP release and; (b) characterize muscarinic agonist‐dependent release. Methods ATP release from young (9‐12 weeks) and aged (24 months) mouse bladder wall was measured in vitro, with a luciferin‐luciferase assay, after stretch or carbachol exposure. Bladder wall stiffness, measured simultaneously during stretch, was compared to histological proportions of connective tissue and detrusor muscle. Results With young mice, stretch‐activated ATP release required an intact mucosa and was positively associated with wall stiffness. ATP release by carbachol was about four‐fold greater compared to stretch. With aged mice: ATP release varied a hundred‐fold and no association with stiffness; carbachol release diminished; connective tissue and mucosa thickness increased. Conclusions With young mice, stretch, or muscarinic agonists potently induce bladder wall ATP release. Stretch‐dependent release is proportional to bladder wall stiffness, independent of the extent of stretch. With aged mice dependence of stretch‐activated ATP release with stiffness was lost. The huge variability of release suggests that aged mice do not form a homogenous cohort and may underlie the heterogeneity in bladder filling sensations.

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Section: Discussionsupporting

confidence: 65%

Stretch‐ and carbachol‐induced ATP release from bladder wall preparations of young and aged mice

Nishikawa

Chakrabarty

Kitney

et al. 2020

Neurourology and Urodynamics

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“…Some of these studies have used a tablet‐based sensation meter that participants used to track real‐time, unprompted bladder sensation . In addition, several previous studies have used three‐dimensional (3D) ultrasound to measure bladder volume, shape, and biomechanics . Together, the use of the sensation meter and ultrasound permits non‐invasive assessments of bladder sensation and function; however, these techniques require participant training on the use of the sensation meter, and bladder sensation is potentially influenced by pressure from the ultrasound probe.…”

Section: Introductionmentioning

confidence: 99%

“…6,8 In addition, several previous studies have used three-dimensional (3D) ultrasound to measure bladder volume, 12 shape, 13 and biomechanics. 14 Together, the use of the sensation meter and ultrasound permits non-invasive assessments of bladder sensation and function; however, these techniques require participant training on the use of the sensation meter, and bladder sensation is potentially influenced by pressure from the ultrasound probe. Furthermore, in a comparison of ambulatory and conventional urodynamics, faster filling led to greater voided volumes in healthy volunteers.…”

Section: Introductionmentioning

confidence: 99%

Validation of a real‐time bladder sensation meter during oral hydration in healthy adults: Repeatability and effects of fill rate and ultrasound probe pressure

Sheen

Kolli

Nagle

et al. 2019

LUTS

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Objectives A non‐invasive protocol was previously developed using three‐dimensional ultrasound and a sensation meter to characterize real‐time bladder sensation. This study the protocol by measuring the effects of fill rateand ultrasound probe pressure during oral hydration. Methods Healthy volunteers with no urinary symptoms (based on International Consultation on Incontinence Questionnaire on Overactive Bladder surveys) were recruited into an oral hydration study. Throughout two complete fill–void cycles, participants drank 2 L Gatorade G2 (The Gatorade Company, Inc., Chicago, Illinois) and used a touch‐screen sensation meter to record real‐time bladder sensation (0%‐100%). The study was repeated three times, once per week (Visits A, B, and C). In Visits A and B, ultrasound was used to measure bladder volume every 5 minutes. Ultrasound was not used in Visit C except at 100% capacity. Volume data from Visit B were used to estimate volumes throughout the fills in Visit C. Sensation–capacity curves were generated for each fill for comparative analysis. Results Ten participants completed three visits (60 total fills). Increased fill rate led to decreased sensation throughout filling, andultrasound probe pressure led to increased sensation. Participants reported higher sensation at low volumes during Fill 1 of Visit A before training with the sensation meter. Sensation curves with intermittent ultrasound showed repeatability for Fill 2 in Visits A and B. Fill rate and ultrasound probe pressure affect real‐time bladder sensation during oral hydration. Conclusions This study demonstrated repeatability of real‐time bladder sensation during a two‐fill oral hydration protocol with ultrasound.

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“…Detrusor wall tension can increase due to filling, with little increase in bladder pressure, and may better correlate with the symptom of urinary urgency. [66][67] Evaluation of OAB symptomatology without DO seen on UDS could possibly be better evaluated with detrusor wall tension. Three dimensional ultrasound has been performed with concurrent UDS to evaluate bladder shape association with LUTS.…”

Section: Emerging Technologies and Methods To Evaluate The Filling Phasementioning

confidence: 99%

New Diagnostics for Male Lower Urinary Tract Symptoms

Swavely

Speich

Stothers

et al. 2019

Curr Bladder Dysfunct Rep

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Purpose of review: Lower urinary tract symptoms (LUTS) is a common constellation of symptoms that affect the aging male population with an astonishing prevalence. New technology and new uses of established technology are being used to help further evaluate LUTS in the male population and help guide treatment options. This review focuses on the developments and future directions in diagnostic modalities for evaluation of male LUTS, focusing on evaluation of both the filling and voiding phases of micturition. Recent findings: New techniques in evaluating the voiding phase include penile cuff test, external pressure sensing condom catheter, ultrasound measurement of detrusor wall thickness, ultrasound measurement of intravesical prostatic protrusion, doppler ultrasound and NIRS technology. Evaluation of the filling phase is still undergoing much development and requires additional validation studies. The techniques undergoing evaluation include sensation meters during UDS, assessing bladder micromotion and wall rhythm, assessing detrusor wall biomechanics, ultrasound measurement of detrusor wall thickness, pelvic doppler ultrasound, as well as functional brain imaging including fNIRS and fMRI. Summary: The development of novel, non-invasive, diagnostic tools have the potential for better evaluation of LUTS with earlier and enhanced treatments. This will likely improve the quality of life for men with LUTS.

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Quantification of bladder wall biomechanics during urodynamics: A methodologic investigation using ultrasound

Cited by 24 publications

References 29 publications

Stretch‐ and carbachol‐induced ATP release from bladder wall preparations of young and aged mice

Stretch‐ and carbachol‐induced ATP release from bladder wall preparations of young and aged mice

Validation of a real‐time bladder sensation meter during oral hydration in healthy adults: Repeatability and effects of fill rate and ultrasound probe pressure

New Diagnostics for Male Lower Urinary Tract Symptoms

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