Can Bladder Wall Thickness Predict Videourodynamic Findings in Children with Spina Bifida?

Abstract

We investigated whether bladder wall thickness measured at specifically defined bladder volumes could predict videourodynamic findings in children with spina bifida. We prospectively investigated patients with spina bifida on intermittent catheterization who underwent ultrasound examination simultaneously with videourodynamics. We evaluated the association between bladder wall thickness measured at maximum cystometric capacity and parameters including age, maximum detrusor pressure during filling or at leak and bladder compliance. Differences in bladder wall thickness measured at each percent maximum cystometric capacity were compared between patients with and without unfavorable videourodynamic findings. Maximum detrusor pressure 40 cm H2O or greater during filling or at leak, bladder compliance less than 10 ml/cm H2O, detrusor overactivity, bladder trabeculation and vesicoureteral reflux were defined as unfavorable videourodynamic findings. A total of 23 males and 30 females with spina bifida (median age 7.8 years) underwent measurement of bladder wall thickness at maximum cystometric capacity. Mean ± SD bladder wall thickness measured at maximum cystometric capacity was 1.7 ± 0.5 mm. Only age had a weak correlation with bladder wall thickness measured at maximum cystometric capacity (p <0.05). In 31 patients bladder wall thickness was measured at each percent maximum cystometric capacity. Regarding unfavorable videourodynamic findings, there were no significant differences in bladder wall thickness measured at each percent maximum cystometric capacity, except for bladder trabeculation. Even if bladder wall thickness is measured at specifically defined bladder volumes, it cannot predict videourodynamic findings other than bladder trabeculation in children with spina bifida.