The clinical significance of poor bladder compliance

Cho, Sung Yong; Yi, Jin Wook; Oh, Seung‐June

doi:10.1002/nau.20713

Cited by 31 publications

(18 citation statements)

References 24 publications

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“…Bladder compliance refers to the viscoelastic behavior of the urinary bladder that is dependent upon the viscoelastic properties of bladder components, including smooth muscle, collagen, and elastin. 4 Chronic inflammation or chronic infection from cystitis secondary to CIC causes lower urinary tract complications. These complications include diverticula and trabeculation of the bladder, low bladder compliance, and low bladder capacity.…”

Section: Discussionmentioning

confidence: 99%

“…These structural complications are difficult to treat. 4 Surgical treatment, such as ureteral reimplantation, external sphincterotomy, open intravesical excision, direct removal of the wall deformity, or augmentation cystoplasty, is used to manage the complicated bladder. Finally, many of these patients who had taken the surgical treatment were found to suffer from early and late complications.…”

Section: Discussionmentioning

confidence: 99%

“…The increasing collagen content decreases the bladder wall's viscoelasticity and results in lower bladder compliance. 4 Several methods for the control of the neurogenic detrusor overactivity have been recommended. Medications such as detrusor muscle relaxant are prescribed for patients with neurogenic detrusor overactivity in order to increase bladder capacity and compliance.…”

Section: Introductionmentioning

confidence: 99%

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The effect of semiconditional dorsal penile nerve electrical stimulation on capacity and compliance of the bladder with deformity in spinal cord injury patients: a pilot study

et al. 2012

Spinal Cord

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Study design: Bladder capacity, bladder compliance, the volume of the first overactive contraction, maximal volume during cystometry (CMG) and the vesicoureteral reflux, bladder wall deformity before and after semiconditional stimulation on DPN. Objectives: To evaluate the effect of the semiconditional electrical stimulation on dorsal penile nerve (DPN) to improve the complicated bladder function in male with spinal cord injury (SCI). Setting: Semiconditional stimulation system and urodynamic laboratory in a university hospital. Participants: Six men (age, 33-59 years) with SCI incurred from 38 to 156 months before this study. Intervention: semiconditional stimulation parameters were set during CMG and semiconditional stimulation on DPN by surface electrodes via Empi Focus stimulator was applied from 14 to 28 days, at home. Parameters about bladder function were measured before and after stimulation applied. Result: All parameters for bladder after semiconditional stimulation were increased. Also, the vesicoureteral reflux and bladder wall deformity was improved in five of six patients. Conclusion: Semiconditional electrical stimulation on DPN effectively suppresses neurogenic detrusor overactivity and distend the bladder physiologically in the SCI patient with a complicated bladder. The bladder capacity and compliance as well as the bladder wall deformity were improved as a result of this treatment. Keywords: spinal cord injuries; electric stimulation therapy/methods; neurogenic detrusor overactivity; neurogenic lower urinary tract symptom; urodynamic studies INTRODUCTIONThe goal of neurogenic bladder management in patients with spinal cord injury (SCI) is to achieve low-pressure urinary storage in bladders with continence, efficient and complete emptying with normal pressures, and preservation of kidney function, as well as preventing urinary tract infections. A poorly compliant bladder distends with high intravesical pressure at relatively low volumes and may lead to vesicoureteral reflux. These problems put the upper urinary tract at an even greater risk for deterioration. 1 Following the suprasacral SCI, the pontine micturition center cannot control bladder function and sphincter activity. Thus, after suprasacral SCI, detrusor overactivity, urethral smooth muscle synergia, and striated urethral muscle dyssynergia can occur. 2 The neurogenic detrusor overactivity correlates closely with low compliance and bladder wall deformity. 3 Neurologic injury and denervation could increase the collagen content in the bladder wall. The increasing collagen content decreases the bladder wall's viscoelasticity and results in lower bladder compliance. 4 Several methods for the control of the neurogenic detrusor overactivity have been recommended. Medications such as detrusor muscle relaxant are prescribed for patients with neurogenic detrusor overactivity in order to increase bladder capacity and compliance. 5 Intravesical administration of capsaicin or resiniferatoxin achieves similar results. However, these above-mentione...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The effect of semiconditional dorsal penile nerve electrical stimulation on capacity and compliance of the bladder with deformity in spinal cord injury patients: a pilot study

et al. 2012

Spinal Cord

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“…3a), whereas those in DUA-LC was high sustained as the P det had reached a relatively high level prior to ordering voiding and did not increase during the voiding phase (Fig. 4a) [12, 13]. If effective detrusor contraction pressure was claimed, the P det ahead of the voiding order should be subtracted from the real-time P det .…”

Section: Methodsmentioning

confidence: 99%

Low-frequency electrotherapy for female patients with detrusor underactivity due to neuromuscular deficiency

Shen

Wang

et al. 2012

Int Urogynecol J

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Introduction and hypothesisThe aim of the study was to assess the efficacy of low-frequency electrotherapy (LFE) for female patients with early-stage detrusor underactivity (DUA) due to neuromuscular deficiency.MethodsA total of 102 female patients were divided randomly into four groups: LFE-NC (normal compliance), LFE-LC (low compliance), CON (control)-NC and CON-LC. Patients in the LFE-NC and LFE-LC groups received LFE, and those in the CON-NC and CON-LC groups received conservative treatment. Urodynamic evaluation was performed before and after treatment.ResultsAfter treatment, 82 % of the LFE-NC regained detrusor contractility, whereas only 2 (8 %) of the CON-NC had normal detrusor contraction. None of LFE-LC or CON-LC regained detrusor contractility (p < 0.01). The per cent of LFE-NC who relied on catheterization for bladder emptying decreased by 43 % (p < 0.01). Those in the LFE-LC, CON-NC and CON-LC groups decreased by only 4, 12 or 0 % (p > 0.05).ConclusionsLFE was more effective for DUA patients with normal compliance; these patients benefited from LFE, but DUA patients with low compliance did not.

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“…Though the exact cause of hypocompliance is not known, it may be caused by changes in the elastic and viscoelastic properties of the bladder, changes in detrusor muscle tone, or combinations of the two (Park, 2010). The lower bladder compliance patterns could be classified into three groups (Cho et al, 2009). Group A (gradual increase) had the highest correlation with the presence of spinal cord injury.…”

Section: Lower Compliance At Second-half Storage Phase As Main Cause mentioning

confidence: 99%

Anal Sphincter Electromyogram for Dysfunction of Lower Urinary Tract and Pelvic Floor

Qu¹,

Xu²,

Wang³

et al. 2011

Advances in Applied Electromyography

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The clinical significance of poor bladder compliance

Abstract: Poor compliance was correlated with the presence of neurological conditions. The gradual increase of detrusor pressure was associated with the development of spinal cord injury, and the terminal increase had an association with a history of treatment to the pelvic cavity.

Cited by 31 publications

References 24 publications

The effect of semiconditional dorsal penile nerve electrical stimulation on capacity and compliance of the bladder with deformity in spinal cord injury patients: a pilot study

The effect of semiconditional dorsal penile nerve electrical stimulation on capacity and compliance of the bladder with deformity in spinal cord injury patients: a pilot study

Low-frequency electrotherapy for female patients with detrusor underactivity due to neuromuscular deficiency

Anal Sphincter Electromyogram for Dysfunction of Lower Urinary Tract and Pelvic Floor

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