Abstract
Lower urinary track symptoms (LUTS) affect many older adults. Multi-channel urodynamic studies provide information about bladder pressure and urinary flow but offer little insight into changes in bladder anatomy and detrusor muscle function. Here we present a novel method for real time MRI during bladder voiding. This was performed in a small cohort of healthy men and men with benign prostatic hyperplasia and lower urinary tract symptoms (BPH/LUTS) to demonstrate proof of principle; The MRI urodynamic protocol was successfully implemented, and bladder wall displacement and urine flow dynamics were calculated. Displacement analysis on healthy controls showed the greatest bladder wall displacement in the dome of the bladder while men with BPH/LUTS exhibited decreased and asymmetric bladder wall motion. Computational fluid dynamics of voiding showed men with BPH/LUTS had larger recirculation regions in the bladder. This study demonstrates the feasibility of performing MRI voiding studies and their potential to provide new insight into lower urinary tract function in health and disease.
Highlights
Lower urinary track symptoms (LUTS) and changes in bladder function occur frequently as individuals age [1,2,3]
We describe a magnetic resonance imaging (MRI) urodynamics method, as well as a patient specific MRIbased computational fluid dynamics (CFD) simulation of bladder voiding
The MRI urodynamics protocol was successfully completed in three healthy volunteers and three patients with BPH/LUTS. 2D planes of the bladder during voiding are shown in Fig 3, Fig 2
Summary
Lower urinary track symptoms (LUTS) and changes in bladder function occur frequently as individuals age [1,2,3]. Studies have evaluated the anatomical and functional changes of the bladder in patients with LUTS [4, 5]; the biomechanical characteristics of the lower urogenital tract, and how these are altered in patients with LUTS, are not fully understood. Lower urinary tract function is commonly assessed through multi-channel urodynamic studies that determine bladder pressure and flow during voiding. These studies can be performed in combination with fluoroscopic imaging to visualize the urine flow during voiding. These studies are invasive and provide little insight into the changes in bladder
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