Clinical findings associated with bladder trabeculations in women
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ORIGINAL ARTICLE
Clinical findings associated with bladder trabeculations in women Meghana Gowda & Jill M. Danford & Yan Hu & James C. Slaughter & Carl W. Zimmerman & Renée M. Ward
Received: 5 August 2012 / Accepted: 27 October 2012 / Published online: 17 November 2012 # The International Urogynecological Association 2012
Abstract Introduction and hypothesis This study evaluated whether bladder trabeculations are associated with advanced prolapse, urinary urgency, or detrusor overactivity among women undergoing office cystoscopy. It is well established that bladder trabeculations are associated with bladder outlet obstruction (BOO) in men; however, the clinical significance of trabeculations in women is unclear. Whereas an analogous relationship has been proposed between prostatic obstruction in men and advanced pelvic organ prolapse (POP) in women, little data in the medical literature supports this theory. Methods A retrospective cohort study was conducted using Current Procedural Terminology (CPT) codes (52000, 52204) to identify all women who underwent office cystoscopy at our urogynecology center between January 2008 and May 2011. The 551 women identified were grouped by the presence or absence of bladder trabeculations. Multivariable logistic regression was used to estimate the association between trabeculations and the primary aim, increasing stage of prolapse, and the secondary aims: bladder outlet obstruction, detrusor overactivity, or urge urinary incontinence (UUI). Results Of the 551 women meeting inclusion criteria, 86 had trabeculations. Controlling for age, the odds of bladder trabeculations were eightfold greater for women with stage IV POP when compared with women with stage 0 prolapse [odds ratio (OR) 8.2, 95 % confidence interval (CI) 1.6–43.1]. The odds of bladder trabeculations were twofold greater for M. Gowda (*) : J. M. Danford : C. W. Zimmerman : R. M. Ward Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Vanderbilt University, B-1100 Medical Center North, Nashville, TN 37232, USA e-mail: [email protected] Y. Hu : J. C. Slaughter Department of Biostatistics, Vanderbilt University, Nashville, TN 37232, USA
women with detrusor overactivity (OR 2.3, 95 % CI 1.3– 4.0) found on urodynamic study and also as reflected subjectively by answers to Pelvic Floor Distress Inventory (PFDI) item number 16 (OR 4.2, 95 % CI 1.3–14.5). Conclusion In this study, bladder trabeculations were associated with stage IV prolapse in the anterior compartment as well as with detrusor overactivity and UUI. Keywords Trabeculations . Pelvic organ prolapse . Detrusor overactivity
Introduction Although bladder trabeculations are associated with bladder outlet obstruction (BOO) in men, the clinical significance of trabeculations in women is unclear. This is partly due to the fact that BOO is rare in women, yet mild to moderate trabeculations are common. In large series of women with voiding dysfunction, incidences of primary obstruction ranged from only 0 % to 0
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