PD37-05 USE OF CONTRAST ENHANCED ULTRASONOGRAPHY WITH URODYNAMICS: A COMPARISON STUDY TO FLUOROSCOPY

Abstract

You have accessJournal of UrologyCME1 Apr 2023PD37-05 USE OF CONTRAST ENHANCED ULTRASONOGRAPHY WITH URODYNAMICS: A COMPARISON STUDY TO FLUOROSCOPY Emmett H. Kennady, Sean T. Corbett, Susan Leroy, Kathryn Morgan, Reza Daugherty, Nicole Kapral, and Nora G. Kern Emmett H. KennadyEmmett H. Kennady More articles by this author , Sean T. CorbettSean T. Corbett More articles by this author , Susan LeroySusan Leroy More articles by this author , Kathryn MorganKathryn Morgan More articles by this author , Reza DaughertyReza Daugherty More articles by this author , Nicole KapralNicole Kapral More articles by this author , and Nora G. KernNora G. Kern More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003335.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Video urodynamics (UDS) has classically been performed using fluoroscopy (fluoro). Contrast enhanced voiding ultrasonography (CeVUS) has been in use to evaluate for genitourinary anomalies but has not been known to be used in conjunction with UDS. We evaluated the ability, quality of using CeVUS UDS and compared the results with fluoro UDS. METHODS: Children ages 0-18 were enrolled for CeVUS UDS who previously underwent fluoro UDS. Demographic data, imaging data for CeVUS and fluoro UDS, time in between studies, and clinical data between studies were recorded. Changes in clinical status between the 2 studies included changes in catheterization, urine leakage between, anticholinergic medications, urinary tract infections, hydronephrosis and neurologic changes. Comparison testing was performed using McNemar’s Chi-Squared and Wilcoxon matched-pairs signed rank test. RESULTS: 53 children were recruited with none declining the study. Table 1 contains demographics and clinical changes between studies. Median time between studies was 1.3 years (IQR 0.9 - 2.9). 53 CeVUS UDS studies were completed with adequate data; none were aborted due to technical reasons. In 4 cases, the bladder neck could not be visualized accurately due to non-mixing and layering of the microbubble contrast against urine (Table 1). Benefits to CeVUS included ability to visualize the exact moment the bladder neck opened. There were no significant differences in bladder shape, presence of vesicoureteral reflux, bladder neck or urethral changes in the cohort at differing time points. Following exclusion of patients with significant changes in medication regimen, catheterization, neuro procedures, hydronephrosis, and UTIs that could lead to changes in UDS imaging findings, a subgroup analysis of 25 patients demonstrated no significant differences in parameters between the 2 studies. CONCLUSIONS: CeVUS can be used adequately in conjunction with urodynamics. Slight limitations to CeVUS include more granular imaging for bladder shape compared to fluoro and inability to visualize bladder neck if residual urine is in the bladder, mitigated by bladder emptying. Benefits include ability to visualize the dynamic activity of the bladder neck due to constant imaging with CeVUS. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e987 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Emmett H. Kennady More articles by this author Sean T. Corbett More articles by this author Susan Leroy More articles by this author Kathryn Morgan More articles by this author Reza Daugherty More articles by this author Nicole Kapral More articles by this author Nora G. Kern More articles by this author Expand All Advertisement PDF downloadLoading ...