Pd07-01 Bladder Shape Does Not Correlate With Upper and Lower Urinary Tract Findings in Children With Spina Bifida

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Neurogenic Voiding Dysfunction (PD07)1 May 2024PD07-01 BLADDER SHAPE DOES NOT CORRELATE WITH UPPER AND LOWER URINARY TRACT FINDINGS IN CHILDREN WITH SPINA BIFIDA Zoe S. Gan, Joey Logan, Ariana L. Smith, Christopher J. Long, Dana A. Weiss, Jason Van Batavia, Stephen A. Zderic, John Weaver, and Gregory E. Tasian Zoe S. GanZoe S. Gan , Joey LoganJoey Logan , Ariana L. SmithAriana L. Smith , Christopher J. LongChristopher J. Long , Dana A. WeissDana A. Weiss , Jason Van BataviaJason Van Batavia , Stephen A. ZdericStephen A. Zderic , John WeaverJohn Weaver , and Gregory E. TasianGregory E. Tasian View All Author Informationhttps://doi.org/10.1097/01.JU.0001008552.16893.70.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Standard nomenclature for bladder shape and its clinical significance are not well defined. The purpose of this study was to 1) classify bladder shapes in children with spina bifida using both expert clinician categorization and unsupervised cluster analysis of fluoroscopic images, and 2) determine if bladder shape is associated with bladder dysfunction severity and/or clinical parameters. We hypothesized that dysfunction would vary among bladder shapes. METHODS: We performed a cross-sectional study of pediatric patients with spina bifida who underwent video urodynamics (VUDS) at a single tertiary center July 2016 - June 2022. Representative fluoroscopic bladder images at 50% functional capacity from the earliest available VUDS study were selected. Unsupervised cluster analysis was applied to features derived from pre-trained machine learning algorithms to classify bladder shape. Images were also assigned to shape categories by pediatric urologists. Clinical characteristics among the bladder shape categories and clusters were compared. The cluster analysis was also applied to a separate cohort of 380 VUDS studies; the degree of bladder dysfunction (mild, moderate, severe) was compared among clusters. RESULTS: Of 449 patients (median age 3.2 years), cluster analysis of VUDS studies yielded 5 bladder shape clusters (Figure 1). Bladder pressure during filling was higher for clusters 2 & 4 and for bladders categorized as trabeculated or "Christmas tree" shape. However, all bladder shapes had some degree of baseline hydronephrosis, reflux during VUDS, and leakage during VUDS (Figure 2). For the 380 VUDS studies with bladder dysfunction ratings, moderately and severely dysfunctional bladders were present across all shape clusters. CONCLUSIONS: In a pediatric spina bifida population, bladder shape may correlate with filling pressure, but it does not independently differentiate the presence of hydronephrosis, reflux, leakage, or bladder dysfunction severity. Establishing a standardized nomenclature may facilitate longitudinal studies on bladder shape. Download PPTDownload PPT Source of Funding: Pennsylvania Department of Health © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e167 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Zoe S. Gan More articles by this author Joey Logan More articles by this author Ariana L. Smith More articles by this author Christopher J. Long More articles by this author Dana A. Weiss More articles by this author Jason Van Batavia More articles by this author Stephen A. Zderic More articles by this author John Weaver More articles by this author Gregory E. Tasian More articles by this author Expand All Advertisement PDF downloadLoading ...