title: Clinical findings associated with bladder trabeculations in women.
abstract: OBJECTIVE
  This study evaluated whether bladder trabeculations are associated with advanced prolapse, urinary urgency, or detrusor overactivity among women undergoing office cystoscopy. It is well established that bladder trabeculations are associated with bladder outlet obstruction (BOO) in men; however, the clinical significance of trabeculations in women is unclear. Whereas an analogous relationship has been proposed between prostatic obstruction in men and advanced pelvic organ prolapse (POP) in women, little data in the medical literature supports this theory.
  
  
  METHODS
  A retrospective cohort study was conducted using Current Procedural Terminology (CPT) codes (52000, 52204) to identify all women who underwent office cystoscopy at our urogynecology center between January 2008 and May 2011. The 551 women identified were grouped by the presence or absence of bladder trabeculations. Multivariable logistic regression was used to estimate the association between trabeculations and the primary aim, increasing stage of prolapse, and the secondary aims: bladder outlet obstruction, detrusor overactivity, or urge urinary incontinence (UUI).
  
  
  RESULTS
  Of the 551 women meeting inclusion criteria, 86 had trabeculations. Controlling for age, the odds of bladder trabeculations were eightfold greater for women with stage IV POP when compared with women with stage 0 prolapse [odds ratio (OR) 8.2, 95% confidence interval (CI) 1.6-43.1]. The odds of bladder trabeculations were twofold greater for women with detrusor overactivity (OR 2.3, 95% CI 1.3-4.0) found on urodynamic study and also as reflected subjectively by answers to Pelvic Floor Distress Inventory (PFDI) item number 16 (OR 4.2, 95% CI 1.3-14.5).
  
  
  CONCLUSIONS
  In this study, bladder trabeculations were associated with stage IV prolapse in the anterior compartment as well as with detrusor overactivity and UUI.
authors.affiliation: Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Vanderbilt University, B-1100 Medical Center North, Nashville, TN 37232, USA. meghanagowda@gmail.com
authors.forename: Meghana
authors.initials: M
authors.lastname: Gowda
authors.forename: Jill M
authors.initials: JM
authors.lastname: Danford
authors.forename: Yan
authors.initials: Y
authors.lastname: Hu
authors.forename: James C
authors.initials: JC
authors.lastname: Slaughter
authors.forename: Carl W
authors.initials: CW
authors.lastname: Zimmerman
authors.forename: Renée M
authors.initials: RM
authors.lastname: Ward
mesh_terms: D000368:Aged; D003558:Cystoscopy; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000473:pathology*; D012189:Retrospective Studies; D001743:Urinary Bladder / Q000473:pathology*; D001748:Urinary Bladder Neck Obstruction / Q000473:pathology*; D053201:Urinary Bladder, Overactive / Q000473:pathology*; D053202:Urinary Incontinence, Urge / Q000473:pathology*