539 USE OF A THREE-DIMENSIONAL SIMULATION MODEL TO DETERMINE THE ETIOLOGY OF VOIDING DYSFUNCTION

Abstract

You have accessJournal of UrologyBladder and Urethra: Anatomy, Physiology and Pharmacology (II)1 Apr 2013539 USE OF A THREE-DIMENSIONAL SIMULATION MODEL TO DETERMINE THE ETIOLOGY OF VOIDING DYSFUNCTION Shigeiro Soh, Koujiro Nishio, Makoto Kawaguchi, Ryo Sato, Shigehiyuki Ohta, Yuko Sadaoka, Yoshio Ashizawa, Yoshitomo Kobori, Hiroshi Yagi, Gaku Arai, and Hiroshi Okada Shigeiro SohShigeiro Soh Koshigaya, Saitama, Japan More articles by this author , Koujiro NishioKoujiro Nishio Koshigaya, Saitama, Japan More articles by this author , Makoto KawaguchiMakoto Kawaguchi Koshigaya, Saitama, Japan More articles by this author , Ryo SatoRyo Sato Koshigaya, Saitama, Japan More articles by this author , Shigehiyuki OhtaShigehiyuki Ohta Koshigaya, Saitama, Japan More articles by this author , Yuko SadaokaYuko Sadaoka Koshigaya, Saitama, Japan More articles by this author , Yoshio AshizawaYoshio Ashizawa Koshigaya, Saitama, Japan More articles by this author , Yoshitomo KoboriYoshitomo Kobori Koshigaya, Saitama, Japan More articles by this author , Hiroshi YagiHiroshi Yagi Koshigaya, Saitama, Japan More articles by this author , Gaku AraiGaku Arai Koshigaya, Saitama, Japan More articles by this author , and Hiroshi OkadaHiroshi Okada Koshigaya, Saitama, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1934AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Urinary tract examination using a three-dimensional (3D) model and virtual endoscopy (VES) provides entirely different information from conventional radiological imaging and endoscopic examinations. For example, VES video imaging of the bladder and urethra enables observation of the morphology of the lumen of the bladder neck and urethra in the same direction as urine flow during voiding, which previously had not been possible. In this study, we used quantified 3D simulation technology to investigate the etiology of voiding dysfunction. METHODS Of 20 boys who presented with a chief complaint of nocturnal enuresis or daytime urinary incontinence and in whom stenosis was suspected based on obstructive patterns on uroflowmetry and voiding cystourethrography, 18 who underwent CT during voiding and for whom a 3D model and a VES video were obtained were included in the study. VES videos were created using a DICOM viewer and a CAD application for medical use Quantification was performed using data such as the curvature of the walls of the interior of the urethra determined from a structural analysis of VES videos. RESULTS The morphology of the bladder and urethra of the subjects was classified into three types based on the three-dimensional model.(fig. 1). Comparison of quantitative data among the types showed clear differences. In particular, a morphology in which the bladder was anteflexed was observed in many cases, and 3D data confirmed that flexion of the urethra due to structural abnormality of the bladder and urethra increased intravesical pressure and bladder wall thickness. This was caused by the positional relationship between the pubic bone and the bladder and urethra. In other words, a structural abnormality of the bladder and urethra that differs from urethral stenosis was observed at a high frequency. CONCLUSIONS These findings suggest that a structural abnormality of the bladder neck and urethra is often involved in cases of childhood-onset refractory voiding dysfunction of non-neurological origin. This finding may have a great effect on treatment strategies for patients with this condition. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e221-e222 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Shigeiro Soh Koshigaya, Saitama, Japan More articles by this author Koujiro Nishio Koshigaya, Saitama, Japan More articles by this author Makoto Kawaguchi Koshigaya, Saitama, Japan More articles by this author Ryo Sato Koshigaya, Saitama, Japan More articles by this author Shigehiyuki Ohta Koshigaya, Saitama, Japan More articles by this author Yuko Sadaoka Koshigaya, Saitama, Japan More articles by this author Yoshio Ashizawa Koshigaya, Saitama, Japan More articles by this author Yoshitomo Kobori Koshigaya, Saitama, Japan More articles by this author Hiroshi Yagi Koshigaya, Saitama, Japan More articles by this author Gaku Arai Koshigaya, Saitama, Japan More articles by this author Hiroshi Okada Koshigaya, Saitama, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...