Bladder compliance

Prostatectomy is ineffective for relieving irritative voiding symptoms of BPH because prostatectomy does not affect the detrusor muscle of the bladder. These patients may respond to oral anticholinergic agents (e.g., oxybutynin or L-hyoscyamine), which improve bladder compliance and decrease detrusor muscle irritability, as discussed in Chap. 83. 

Kelleher CJ, Cardozo LD, Khullar S. A medium term analysis of the subjective efficacy of treatment for women with detrusor instability and low bladder compliance. Obstet Gynecol 1997 104 988-993. 

It is well known that subvesical obstruction leads to bladder hypertrophy, reduced bladder compliance and capacity, high detrusor pressure during bladder filling and voiding, and unstable detrusor contractions. Based on this well-known pathophysiological mechanism, the speculative conclusion could... 

Ukimura et al. (1998) described in 1998 that ultrasound-estimated bladder weight might be used to evaluate bladder compliance in children and con-... 

Myelomeningocele is the most common cause of the neurogenic bladder in children. Pressure volume characteristics determine the fate of the urinary tract. There are three predictive indicators for upper tract deterioration detrusor sphincter dyssynergia, high bladder-filling pressure, and poor bladder compliance. Expectant treatment can no longer be advocated. 

Fig. 16.3. Estimation of poor bladder compliance by modified VCU (V bladder filling volume PyEs vesical pressure)...

Preservation of the upper urinary tract is the central goal in the treatment of neurogenic bladder in children with myelodysplasia. Predictive indicators for upper urinary-tract fate are detrusor sphincter dys-synergia, high bladder-filling pressure, poor bladder compliance, moderate to severe fibrosis of the detrusor (OzKAN et al. 2005), high leak-point pressure, and vesicoureteric reflux (Seki et al. 2004). 

Ghoniem GM, Bloom DA, McGuire EJ et al (1989) Bladder compliance in meningomyelocele children. J Urol 141 1404-1406... 

Ghoniem GM, Roach MB, Lewis VH et al (1990) The value of leak pressure and bladder compliance in the urodynamic evaluation of meningomyelocele patients JUrol 144 1440-1442... 

The type of ureterovesical anastomosis chosen depends on the initial radiological images, the condition of the graft s ureter and intra-operative observations (quality of exposure, the healthy appearance of the bladder, compliance during filling via a catheter). 

Normal function, then, requires organ system integrity (Fig. 51.1). Muscular and vascular apparatuses are equally important to sensory and motor innervation (Elbadawi, 1973). In the bladder, for example, muscular function includes storage (distensibility, or compliance) as well as elimination (coordinated muscular contractions) and therefore requires appropriate sphincter tone, contraction, and relaxation. Neurovascular bundles provide critical vascular and neural input and output for all pelvic subunits (Daniel et ah, 1983). 

The effect of substances on the compliance of the bladder wall is evaluated by comparing the volume-pressure-relationship of treated animals with that of controls. 

Cisapride can cause functional changes in the urinary tract because of increased pressure in the bladder, which may be a problem in individuals with hyperactive bladders. In individuals who had complete traumatic spinal cord injury, the increase in reflex bladder contractions was sufficient to reduce compliance markedly (23). 

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