A pilot study of bladder voiding with real-time MRI and computational fluid dynamics

• Published in: PloS one Vol. 15; no. 11; p. e0238404
• Main Authors: Pewowaruk, Ryan, Rutkowski, David, Hernando, Diego, Kumapayi, Bunmi B., Bushman, Wade, Roldán-Alzate, Alejandro
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 19.11.2020; Public Library of Science (PLoS)
• Subjects: Adult; Aged; Analysis; Biology and Life Sciences; Biomedical engineering; Bladder; Bladder diseases; Catheters; Cohort Studies; Computational fluid dynamics; Computer applications; Diagnosis; Displacement; Feasibility studies; Fluid dynamics; Health aspects; Humans; Hydrodynamics; Hyperplasia; Lower Urinary Tract Symptoms - physiopathology; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Male genital diseases; Medicine and Health Sciences; Methods; Middle Aged; Muscles; Older people; Patients; Physical Sciences; Physiological aspects; Pilot Projects; Prostatic Hyperplasia - physiopathology; Real time; Regions; Research and Analysis Methods; Scanners; Signs and symptoms; Urinary Bladder - physiology; Urinary Bladder - physiopathology; Urinary tract; Urination; Urodynamics - physiology; Urogenital system; Urology; United States; United States > US
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0238404

Lower urinary track symptoms (LUTS) affect many older adults. Multi-channel urodynamic studies provide information about bladder pressure and urinary flow but offer little insight into changes in bladder anatomy and detrusor muscle function. Here we present a novel method for real time MRI during bladder voiding. This was performed in a small cohort of healthy men and men with benign prostatic hyperplasia and lower urinary tract symptoms (BPH/LUTS) to demonstrate proof of principle; The MRI urodynamic protocol was successfully implemented, and bladder wall displacement and urine flow dynamics were calculated. Displacement analysis on healthy controls showed the greatest bladder wall displacement in the dome of the bladder while men with BPH/LUTS exhibited decreased and asymmetric bladder wall motion. Computational fluid dynamics of voiding showed men with BPH/LUTS had larger recirculation regions in the bladder. This study demonstrates the feasibility of performing MRI voiding studies and their potential to provide new insight into lower urinary tract function in health and disease.