The Low Compliance Bladder

Abstract

Compliance is defined as the increase in pressure per unit of volume (V/P). Normally the bladder is very compliant and may be filled to large volumes with very little increase in detrusor pressure. The low compliance bladder results from intrinsic disease processes within the bladder wall which result in fibrosis and decreased elasticity. This decreased elasticity of the bladder wall is reflected in the urodynamic tracing as a loss of accommodation with a gradual pressure increase during filling. This is frequently associated with a diminished bladder capacity in conditions such as radiation cystitis. When the lack of bladder wall compliance results in bladder pressure equalization with the urethra, incontinence results in a pattern similar to the atonic bladder when the bladder can distend no longer but at much smaller volumes.