Bladder height to width ratio as a surrogate marker for non-physiological storage pressures in children with spinal dysraphism

Topic overview

Key takeaways

• Bladder height-to-width ratio (HWR) ≥1.3 on cystogram predicts non-physiological storage pressures (≥30 cmH2O) with 87.5% sensitivity in spinal dysraphism.
• HWR offers objective bladder shape assessment when urodynamic studies are unavailable or technically difficult in pediatric neurogenic bladder patients.
• Vertically elongated bladders (higher HWR) correlate with elevated detrusor pressures, enabling non-invasive screening for high-risk bladders.
• HWR calculated at maximum cystometric capacity using standard formulas provides reproducible measurement for longitudinal neurogenic bladder monitoring.
• This imaging-based surrogate marker may reduce reliance on invasive urodynamics while identifying children needing aggressive bladder management.

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