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Also known as
Low bladder compliance, Low compliance bladder
Definition
Bladder compliance is defined as the change in bladder volume (ΔV in mL) divided by the change in pressure (ΔPdet in cm H2O). It generally refers to the bladder’s ability to accommodate an increase in volume with a negligible increase in pressure. Poor compliance indicates a stiff bladder wall that doesn’t expand normally, causing a rapid pressure rise. Studies have identified decreased compliance as a risk factor for upper tract deterioration, often citing a compliance of 10 mL/cm H2O or below as high risk. However, there have also been contradictory studies that have failed to show compliance as a risk factor for upper tract deterioration. There are inherent inaccuracies when using compliance as a parameter for pediatric bladder evaluation. For example, a fast fill rate can lead to poor compliance due to stretch-induced opening of calcium channels and activation of actin-myosin cross-bridge cycling, which provides resistance to deformation.¹
Clinical Context
Poor bladder compliance is often correlated with the presence of neurological conditions, such as spinal cord injury. It can also be associated with a history of pelvic irradiation, radical prostatectomy, and tethered cord syndrome. Vesicoureteral reflux and detrusor overactivity may also be present in patients with poor compliance. The clinical significance of poor bladder compliance lies in its potential to lead to upper urinary tract deterioration.