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      A pilot study of bladder voiding with real-time MRI and computational fluid dynamics

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          Abstract

          Lower urinary track symptoms (LUTS) affect many older adults. Multi-channel urodynamic studies provide information about bladder pressure and urinary flow but offer little insight into changes in bladder anatomy and detrusor muscle function. Here we present a novel method for real time MRI during bladder voiding. This was performed in a small cohort of healthy men and men with benign prostatic hyperplasia and lower urinary tract symptoms (BPH/LUTS) to demonstrate proof of principle; The MRI urodynamic protocol was successfully implemented, and bladder wall displacement and urine flow dynamics were calculated. Displacement analysis on healthy controls showed the greatest bladder wall displacement in the dome of the bladder while men with BPH/LUTS exhibited decreased and asymmetric bladder wall motion. Computational fluid dynamics of voiding showed men with BPH/LUTS had larger recirculation regions in the bladder. This study demonstrates the feasibility of performing MRI voiding studies and their potential to provide new insight into lower urinary tract function in health and disease.

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          Numerical analysis of blood flow in the heart

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            Flow patterns around heart valves: A numerical method

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              Urologic diseases in America project: benign prostatic hyperplasia.

              Benign prostatic hyperplasia (BPH), the most common benign neoplasm in American men, is a chronic condition that is associated with progressive lower urinary tract symptoms and affects almost 3 of 4 men during the seventh decade of life. Approximately 6.5 million of the 27 million white men who are 50 to 79 years old in the United States in 2000 were estimated to meet the criteria for discussing treatment. The analytical methods used to generate these results have been described previously. In 2000 approximately 4.5 million visits were made to physician offices to for a primary diagnosis of BPH and almost 8 million visits were made with a primary or secondary diagnosis of BPH. In the same year approximately 87,400 prostatectomies for BPH were performed in inpatients in nonfederal hospitals in the United States. While the number of outpatient visits for BPH increased consistently during the 1990s, there was a dramatic decrease in the use of transurethral prostatectomy, inpatient hospitalization and length of hospital stay for this condition. These trends reflect the changing face of medical management for BPH, ie increasing use of pharmacological agents and minimally invasive therapies. In 2000 the direct cost of BPH treatment was estimated to be $1.1 billion exclusive of outpatient pharmaceuticals. Given the impact that BPH has on quality of life and health care cost in millions of American men, additional research into risk factors, diagnostic and therapeutic resource use, and effectiveness and cost benefit of therapies are warranted.
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                Author and article information

                Contributors
                Role: Data curationRole: MethodologyRole: Writing – original draftRole: Writing – review & editing
                Role: Data curationRole: MethodologyRole: SoftwareRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: MethodologyRole: Writing – review & editing
                Role: InvestigationRole: Methodology
                Role: ConceptualizationRole: Funding acquisitionRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: MethodologyRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                19 November 2020
                2020
                : 15
                : 11
                : e0238404
                Affiliations
                [1 ] Biomedical Engineering, University of Wisconsin–Madison, Madison, WI, United States of America
                [2 ] Cardiovascular Research Center, University of Wisconsin–Madison, Madison, WI, United States of America
                [3 ] Radiology, University of Wisconsin–Madison, Madison, WI, United States of America
                [4 ] Medical Physics, University of Wisconsin–Madison, Madison, WI, United States of America
                [5 ] Urology, University of Wisconsin–Madison, Madison, WI, United States of America
                [6 ] Mechanical Engineering, University of Wisconsin–Madison, Madison, WI, United States of America
                University of Oklahoma Health Sciences Center, UNITED STATES
                Author notes

                Competing Interests: The authors have read the journal’s policy and have the following potential competing interests: the authors received CONVERGE licenses through a partnership between Convergent Science Inc. and the University of Wisconsin – Madison. This does not alter our adherence to PLOS ONE policies on sharing data and materials. There are no patents, products in development or marketed products associated with this research to declare.

                Author information
                https://orcid.org/0000-0003-1190-7196
                https://orcid.org/0000-0003-4149-4038
                Article
                PONE-D-20-10274
                10.1371/journal.pone.0238404
                7676741
                33211706
                899d70d1-74a4-43ce-9e30-2d54f7cc5831
                © 2020 Pewowaruk et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 9 April 2020
                : 16 October 2020
                Page count
                Figures: 7, Tables: 0, Pages: 10
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/100000062, National Institute of Diabetes and Digestive and Kidney Diseases;
                Award ID: K12DK100022
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/100000050, National Heart, Lung, and Blood Institute;
                Award ID: T32 HL 007936
                Award Recipient :
                This work was supported by the National Institutes for Health ( nih.gov) grants K12DK100022 (AR, DH, WB) and T32 HL 007936 (RP, DR). The authors also wish to acknowledge support from GE Healthcare who provides research support to the University of Wisconsin. CONVERGE licenses were provided by a partnership between Convergent Science Inc. and the University of Wisconsin – Madison. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Biology and Life Sciences
                Anatomy
                Renal System
                Bladder
                Medicine and Health Sciences
                Anatomy
                Renal System
                Bladder
                Medicine and Health Sciences
                Diagnostic Medicine
                Diagnostic Radiology
                Magnetic Resonance Imaging
                Research and Analysis Methods
                Imaging Techniques
                Diagnostic Radiology
                Magnetic Resonance Imaging
                Medicine and Health Sciences
                Radiology and Imaging
                Diagnostic Radiology
                Magnetic Resonance Imaging
                Medicine and Health Sciences
                Urology
                Urodynamics
                Biology and Life Sciences
                Anatomy
                Renal System
                Medicine and Health Sciences
                Anatomy
                Renal System
                Physical Sciences
                Physics
                Classical Mechanics
                Continuum Mechanics
                Fluid Mechanics
                Fluid Dynamics
                Biology and Life Sciences
                Anatomy
                Body Fluids
                Urine
                Medicine and Health Sciences
                Anatomy
                Body Fluids
                Urine
                Biology and Life Sciences
                Physiology
                Body Fluids
                Urine
                Physical Sciences
                Physics
                Classical Mechanics
                Continuum Mechanics
                Fluid Mechanics
                Fluid Dynamics
                Flow Rate
                Physical Sciences
                Physics
                Classical Mechanics
                Continuum Mechanics
                Fluid Mechanics
                Fluid Dynamics
                Fluid Flow
                Custom metadata
                All relevant data are within the manuscript and its Supporting Information files.

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