Bladder neck position differences on CT in patients with incidental asymptomatic urinary bladder gas: A comparative retrospective study

Objective: To investigate the potential link between differences in bladder neck position and the occurrence of incidental asymptomatic urinary bladder gas on computed tomography (CT) scans in female patients.

Methods: CT scans reports from January 2012 to December 2023 were analyzed in this retrospective study to identify adults presenting with bladder gas. Exclusion was based on factors such as prior urological procedures, urinary tract infections (UTIs), and other potential contributors to bladder gas. The distance between the bladder neck and the pubococcygeal line (B-PCL) was measured to assess bladder neck position. Patients without bladder gas, matched by age and sex, were selected as the control group. The B-PCL distances between the study and control groups were compared, and the reliability of the measurements was assessed through inter- and intra-reader agreement analysis.

Results: Out of 1322 initial patients, 66 satisfied the inclusion criteria, with a median age of 70.9 years (IQR: 64.3-78.0) and a female majority (93.9 %). Among female patients, the median B-PCL distance was significantly shorter in the study group (5.3 mm) compared to controls (9.3 mm) (p = 0.002), suggesting a correlation between bladder neck position and bladder gas. Reliability measures indicated strong agreement among assessments (ICC > 0.95).

Conclusion: Preliminary findings suggest a correlation between lower bladder neck position and the presence of bladder gas on CT scans.

Critical relevance: This study sheds light on a possible association between bladder neck position and incidental bladder gas on CT scans, which may inform future diagnostic and clinical considerations.

Key points: Study examines bladder gas's incidental detection and bladder neck position via CT. Among females, shorter bladder neck to pubococcygeal line distance correlates with bladder gas. Identifying this link may suggest that a low bladder position could facilitate the presence of bladder gas.