Bladder Filling and Storage: “Compliance”
Compliance is a reproducible and reliable urodynamic measurement to evaluate urine storage pressures and the risk of upper tract damage. There is no agreed upon normative value for compliance but most sources cite that it lies somewhere between 10 and 20 ml/cm H2O and can be calculated by evaluating the change in volume compared to the change in detrusor pressure at two given points. Normally, the bladder accommodates filling and stores urine at low pressures due to the viscoelastic properties of the bladder, but various pathologies can cause abnormalities in bladder compliance. This chapter discusses the clinical evaluation, urodynamic tracing, and differential diagnosis of many conditions associated with abnormal compliance such as cerebrovascular accident, bladder outlet obstruction, spinal cord injury, transverse myelitis, multiple sclerosis, and pelvic surgery. It also reviews clinical scenarios that can be falsely interpreted as abnormal compliance. Therefore, the urodynamic compliance measurement provides invaluable information about a patient’s bladder filling and urinary storage and also helps to guide medical and surgical treatment options which are discussed throughout this chapter.
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