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  1. #1

    Trabeculation

    I have used reflex voiding for the past 32 years and my last annual ultrasound showed some mild trabeculation of the bladder wall. I have visited the spinal unit in Brisbane Australia and the doctor wanted me to send the films directly to him so their urologist could go over this change. I had a sphincterotomy immediately postaccident. The ultrasound was done whilst sitting for the very first time and I would like to know whether this method is as good as lying down. Anyway I received another reminder letter for an annual ultrasound and would like to know whether I should insist I be laying down and if there is any difference between the 2 methods. As I am sending the films off to the urologist I want to use the best method for clarity.
    It's probably time for a suprapubic catheter considering the bladder wall is thickening.
    Thanks in advance.
    Steve

    This message was composed using voice recognition, there may be mistakes.

  2. #2
    Trabeculations are little out pouchings seen with neurogenic detrusor overactivity and is common. It is common to have trabeculations because of the high pressure. Is your sphincterotomy emptying well. Sometimes scar tissue will develop and retain urine.With the sphincterotomy emptying you should not be having high pressure. If we have bladder wall thickening it is usually nothing but the urologist will do a cystoscopy and bladder washing just to be sure no abnormal cells.
    If you have an SPTube and the sphincterotomy is open the urologist will need to do a urethral closure also. with the SPTube.
    CWO

  3. #3
    I'm actually having a little more difficulty emptying lately hence my concern. Is there any difference between lying flat and having an ultrasound done sitting i.e. are they both equal?
    Thank you
    Steve

  4. #4
    As far as trabeculations -no. What is your post void residual?
    A bladder scanner can determine this or you can cath after voiding. If high then the sphincterotomy is too closed.
    CWO

  5. #5
    Trabeculation is a sign of a bladder that has been trying to empty with high pressures for some time. It is a thickening of the bladder wall muscle, and can also change the shape of the bladder.

    When did you last have urodynamics including a CMG (cystometrogram)? This should be done every 2-3 years for anyone doing reflex voiding to keep on top of high pressures. It is possible that your long-ago sphincterotomy has scarred down and needs to be repeated, but this does not always remedy high pressures.

    These high pressure can also cause reflux of urine, hydronephrosis, and kidney damage, and increase your risks for UTIs and AD. This is one of the reason that we no longer recommend reflex voiding for people with SCI.

    Ultrasound as a method for determining bladder volume or ureter status is best done laying down, but can also be done in a sitting position if necessary.

    (KLD)

  6. #6
    Urodynamics is long overdue so I will start the process in getting another ultrasound while lying down, refer the films to the spinal unit urologist and follow the advice.
    Thanks for all the advice.
    Steve

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