Glass Clark Stephanie, Nagle Anna S, Bernardo Rachel, Vinod Naomi, Carucci Laura, Carroll Ashley, Speich John, Klausner Adam P
From the Department of Obstetrics and Gynecology, Virginia Commonwealth University Health System.
Department of Mechanical and Nuclear Engineering.
Female Pelvic Med Reconstr Surg. 2020 Oct;26(10):635-639. doi: 10.1097/SPV.0000000000000638.
The objective of this study was to identify differences in bladder shape changes between individuals with overactive bladder (OAB) and unaffected individuals during ultrasound urodynamics.
A prospective urodynamic study was performed with concurrent transabdominal ultrasound (ultrasound urodynamics) on individuals with and without OAB based on validated International Consultation on Incontinence Questionnaire - OAB survey scores. Three-dimensional ultrasound images were acquired at 1-minute increments during filling and used to measure bladder diameters in the height, width, and depth orientations. The engineering strain for each diameter was compared between participants with OAB and controls during urodynamic filling. The height-to-width ratio at capacity was used to determine if individuals were shape outliers.
A total of 22 subjects were enrolled, including 11 with OAB and 11 without OAB. During urodynamic filling in both groups, the greatest degree of geometric strain was found in the height orientation, indicating that bladders generally fill in a craniocaudal shape. The mean ± SD height-to-width ratio of the control group was 1.06 ± 0.12 yielding a 95% confidence interval of 0.82 to 1.30. Five (45.5%) of 11 OAB subjects had height-to-width ratios outside this interval as compared with none of the control subjects, identifying a potential shape-mediated subgroup of OAB.
Three-dimensional ultrasound urodynamics can be used to identify differences in bladder shape comparing individuals with and without OAB. This method may be used to identify a subset of OAB patients with abnormal bladder shapes which may play a role in the pathophysiology of their OAB symptoms.
本研究的目的是确定膀胱过度活动症（OAB）患者与未受影响个体在超声尿动力学检查期间膀胱形状变化的差异。
基于经过验证的《国际尿失禁咨询委员会-OAB调查问卷》评分，对有和没有OAB的个体进行了前瞻性尿动力学研究，并同时进行经腹超声检查（超声尿动力学）。在充盈过程中，以1分钟的间隔采集三维超声图像，并用于测量膀胱在高度、宽度和深度方向上的直径。在尿动力学充盈期间，比较了OAB患者和对照组每个直径的工程应变。使用容量时的高宽比来确定个体是否为形状异常者。
共纳入22名受试者，其中11名患有OAB，11名未患OAB。在两组的尿动力学充盈过程中，发现高度方向上的几何应变程度最大，这表明膀胱通常以头尾方向充盈。对照组的平均±标准差高宽比为1.06±0.12，95%置信区间为0.82至1.30。11名OAB受试者中有5名（45.5%）的高宽比超出此区间，而对照组受试者均未超出，从而确定了一个潜在的由形状介导的OAB亚组。
三维超声尿动力学可用于比较有和没有OAB的个体之间膀胱形状的差异。该方法可用于识别膀胱形状异常的OAB患者亚组，这些异常形状可能在其OAB症状的病理生理学中起作用。
