EN
TÜRKÇE
Oral Presentation - 21
Non-invasive quantitative assessment of urethral compliance in rabbit tubularized incised plate model using ultrasound and uroflowmetry
Hongbo Liu 1, Wei Ru 1, Juan Zhou 1, Ciyuan Feng 2, Qibo Hu 1, Guangjie Chen 1, Weifeng Yang 1, Lizhe Hu 1, Xiang Yan 1
1 Department of Urology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Centre for Child Health, Hangzhou, China
2 Department of Ultrasound, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Centre for Child Health, Hangzhou, Zhejiang, China
Purpose: Low urinary flow rates are frequently observed following tubularized incised plate urethroplasty in pediatric patients. The underlying cause is not yet fully understood and may be associated with low urethral compliance. As most currently reported methods for assessing urethral compliance are invasive, their clinical application remains limited. The purpose of this study is to non-invasively evaluate the urethral compliance in a rabbit model.
Methods: Ten male New Zealand rabbits were randomly divided into a control group and a tubularized incised plate urethroplasty group. At 7 weeks postoperatively, ex vivo urethral compliance was assessed using both the previously reported invasive method by Jesus (ΔVolume/ΔPressure via air insufflation) and a novel non-invasive method developed in this study (ΔDiameter/Δmaximum urinary flow rate via ultrasound and uroflowmetry). Group differences were analyzed using the Mann-Whitney U test, and the agreement between the two methods was evaluated using Bland-Altman plot. A p-value < 0.05 was considered statistically significant.
Results: The Jesus method indicated median urethral compliance was 0.141 [interquartile range (IQR) 0.137, 0.149] ml/cmH2O for the control group and 0.182 (IQR 0.173, 0.192) ml/cmH2O for the urethroplasty group, with no significant difference. The median urethral compliance measured by non-invasive method in the control group was 0.247 (IQR 0.241, 0.257) mm•s/ml, and it was 0.269 (IQR 0.263, 0.270) mm•s/ml in the urethroplasty group, with no significant difference. A strong correlation was found between the two methods (Spearman’s rho = 0.878), and Bland-Altman analysis demonstrated good agreement without systematic bias.
Conclusion: In the rabbit model, urinary flow rate and anterior-posterior diameter serve as non-invasive indicators that can effectively reflect urethral compliance, and tubularized incised plate urethroplasty has no significant impact on urethral compliance. The effectiveness of non-invasive methods for assessing urethral compliance in pediatric patients requires further validation.