{ "vercy": "1.0-draft", "publication": { "status": "research-draft", "adjudicationStatus": "unreviewed", "publishableCanonical": false, "generatedAt": "2026-09-07T09:35:06Z", "providers": [ "Codex", "Grok" ], "missingProviders": [], "pass": 2, "cost": { "grok": { "usd": 0.01163446, "turns": 1, "seconds": 133.5, "error": null }, "codex": { "seconds": 83.9, "error": "Reading additional input from stdin...\nOpenAI Codex v0.153.3\n--------\nworkdir: R:\\02_PROJECTS\\02_Meta_Models_Platforms\\Ver.cy\\current\\thing-registry-backlog\nmodel: gpt-6-astra\nprovider: openai\napproval: never\nsandbox: read-only\nreasoning effort: none\nreasoning summaries: none\nsession id: 01a07b34-36fa-76b0-b966-7544ef3423d8\n--------\nuser\nYou are drafting a Vercy meta-model for one registered thing. Answer as JSON only, no prose around it.\n\nThing: urinary bladder\nRegistry id: vr.tr.urinary-bladder\nPlane / domain: PHY / PHY.LIV\nRegistry definition: (none recorded)\nNames folded into this entry: (" } }, "enrichment": { "pass": 3, "engine": "claude", "producedAt": "2026-10-06T12:00:00Z", "ingestedAt": "2026-10-06T08:09:09+00:00", "fields": [ "agent_conduct", "ethics", "failure_modes_and_hazards", "owners", "visual_identification" ] }, "revisions": [ { "at": "2026-10-07T11:41:53+00:00", "engine": "codex", "fields": [ "definition", "visual_identification" ], "answering_review": "f77efbd200ed355a8ab53579df508f28d20ce92044281f27328268fc79ed2a7b" } ], "gate": { "passed": true, "version": "1.0", "at": "2026-10-07T12:16:35+00:00", "evidence": [ "completeness 1.00", "sense: Wikidata description", "5 live sources", "review by codex: pass" ] } }, "metaModel": { "id": "THING-Q9382", "registryId": "vr.tr.urinary-bladder", "name": "urinary bladder", "version": "0.1.0-research.1", "entryKind": "thing", "family": "Thing Registry", "domain": [ "PHY.LIV" ], "status": "research-draft" }, "canonicalUrl": "https://ver.cy/models/thing/q9382/", "model": { "registry_id": "vr.tr.urinary-bladder", "name": "urinary bladder", "purpose": "Enable an AI agent to recognise a urinary bladder, record its storage and emptying state, and identify which assessments or interventions require further evidence or clinical authority.", "definition": "The urinary bladder is a distensible hollow organ that stores urine before its release in vertebrates that possess one, with location, wall structure, urinary connections and control varying by species and developmental stage; in humans it is largely extraperitoneal and located in the true pelvis, with a urothelial lining and detrusor muscle, receiving urine from the paired ureters and emptying through the urethra under coordinated autonomic and somatic control.", "scope_statement": "This model owns the urinary bladder as an individual biological organ, including its wall, lumen, urine-storage and expulsion functions, and interfaces with ureters, urethra, supporting tissues and neural control; anatomical expectations must be qualified by species and developmental stage.", "in_scope": [ "Organ identity, anatomical boundaries and native or surgically altered configuration", "Bladder wall, lining, lumen and local structural abnormalities", "Filling, storage pressure, capacity and wall compliance", "Detrusor activity, bladder sensation and emptying performance", "Bladder-specific observations, devices, interventions and unresolved concerns" ], "out_of_scope": [ "Renal filtration and urine production, owned by kidney models", "Ureteral anatomy and transport beyond the bladder junctions", "Urethral, sphincter, prostate and pelvic-floor structures beyond their bladder interfaces", "Whole-person fluid balance, neurological disease and systemic infection", "Urine composition as a specimen, except where it supplies evidence about bladder state", "Intestinal urinary reservoirs and external collection bags as substitutes with their own identities" ], "distinguishing_features": [ "Identify a biological urinary reservoir connected to the urinary drainage pathway; a gallbladder belongs to the biliary pathway.", "Distinguish a storage lumen with an organ wall from the conducting lumen of a ureter or urethra using anatomical continuity and observed configuration.", "Distinguish the bladder from a cyst or other fluid-filled structure by demonstrating its urinary connections or documented organ identity.", "Distinguish native bladder tissue, augmented bladder and a replacement reservoir from operative history and tissue origin.", "Distinguish the organ from its urine contents and any inserted catheter; either can change without changing organ identity." ], "characteristics": [ { "name": "Biological context", "kind": "relation", "unit_or_values": "Host organism, species, developmental stage and relevant anatomical context", "why_it_matters": "Determines which anatomical expectations and functional reference values apply." }, { "name": "Anatomical configuration", "kind": "category", "unit_or_values": "Native, surgically repaired, augmented, partially resected, other documented configuration, unknown", "why_it_matters": "Changes organ boundaries and the interpretation of function and access." }, { "name": "Urinary pathway connections", "kind": "relation", "unit_or_values": "Identified ureteral entries, bladder outlet and any surgically created drainage connection", "why_it_matters": "Establishes identity and routes through which urine enters or leaves." }, { "name": "Observed intravesical volume", "kind": "measurement", "unit_or_values": "mL, with time, method and filling or voiding phase", "why_it_matters": "Describes current filling without confusing it with capacity." }, { "name": "Assessed storage capacity", "kind": "measurement", "unit_or_values": "mL, with functional or test-defined endpoint and assessment conditions", "why_it_matters": "Capacity depends on how its endpoint is established." }, { "name": "Storage pressure and compliance", "kind": "measurement", "unit_or_values": "Pressure in cmH2O; compliance in mL/cmH2O; identify pressure type, calculation and filling interval", "why_it_matters": "Volume alone cannot describe the pressure response during storage." }, { "name": "Post-void residual", "kind": "measurement", "unit_or_values": "mL, with elapsed time after voiding and measurement method", "why_it_matters": "Records emptying outcome while preserving conditions that affect interpretation." }, { "name": "Detrusor activity", "kind": "state", "unit_or_values": "Observed contraction pattern during filling and voiding, assessment method, interpretation or unknown", "why_it_matters": "Helps distinguish storage activity from the contraction associated with emptying." }, { "name": "Bladder sensation", "kind": "state", "unit_or_values": "Reported filling sensation, urgency, pain, absent report, not assessable or unknown", "why_it_matters": "Separates subjective experience from measured volume and pressure." }, { "name": "Wall and lumen findings", "kind": "state", "unit_or_values": "Located observations of wall continuity, lining, thickness, lesions, stones, debris or other abnormalities, with method and filling state", "why_it_matters": "Supports local assessment without treating an observation as a confirmed diagnosis." }, { "name": "Drainage device relationship", "kind": "relation", "unit_or_values": "Device identity, route, position, purpose and observed drainage status, or no device documented", "why_it_matters": "Device-mediated drainage changes how native emptying can be assessed." } ], "affordances": [ "Identify and localise the bladder and its urinary connections from documented anatomy or examination evidence.", "Record and compare filling volume, storage pressure and emptying results under stated conditions.", "Associate symptoms and local findings with the bladder while preserving alternative sources and diagnostic uncertainty.", "Track bladder-directed drainage, sampling, imaging, endoscopic assessment or surgery as proposed or performed actions with their prerequisites.", "Flag observations for qualified review using applicable clinical criteria and track the resulting decision." ], "agent_conduct": { "may": [ "Explain the bladder's anatomy and role in storing and voiding urine from medical sources.", "Label the bladder on anatomical diagrams and teaching images." ], "must_not": [ "Diagnose bladder cancer, infection or retention in a specific person without a clinician.", "Advise a person to ignore blood in the urine or inability to pass urine.", "Share a person's continence, catheter or urology records beyond their care team.", "Mock or stigmatise people living with incontinence." ], "requires_human": [ "Any decision on catheterisation, surgery or treatment for a patient.", "Interpreting a scan or test result for a patient." ] }, "ethics": { "considerations": [ "Bladder problems touch on intimate care and dignity and are often hidden out of shame.", "Delayed care for retention or blood in the urine can cause lasting harm." ], "affected_parties": [ "Patients", "People living with incontinence", "Carers" ] }, "owners": { "steward": "The patient with their treating clinicians; nobody owns the organ.", "master_systems": [] }, "visual_identification": [ "In humans, the urinary bladder is a hollow muscular sac located behind the pubic bone when relatively empty, with position and extent changing as it fills.", "On ultrasound, it generally appears as a dark fluid-filled shape whose size changes with filling.", "Its location and urinary connections must be interpreted according to species and developmental stage." ], "failure_modes_and_hazards": [ "Urinary retention can damage the kidneys if not relieved.", "Infections can spread to the kidneys and blood.", "Injury in pelvic trauma can leak urine into the abdomen." ], "what_it_is_for": [ "The urinary bladder stores urine between episodes of urination in humans and many other vertebrates.", "It is examined in anatomy, diagnostic imaging and clinical assessment of urinary storage and emptying." ], "standards_and_regulation": [ "The International Classification of Diseases, Tenth Revision, issued by the World Health Organization, classifies human bladder disorders within its disease categories." ] }, "sources": [ { "id": "grays-anatomy", "title": "Gray's Anatomy: The Anatomical Basis of Clinical Practice", "url": "", "what_it_supports": "Gross anatomy, relations, trigone, detrusor, innervation, and developmental origin from the urogenital sinus." }, { "id": "ta2-fipat", "title": "Terminologia Anatomica, 2nd edition", "url": "", "what_it_supports": "Official Latin and English anatomical name (vesica urinaria / urinary bladder) and partonomy used in teaching and coding." }, { "id": "wikipedia-urinary-bladder", "title": "Urinary bladder", "url": "https://en.wikipedia.org/wiki/Urinary_bladder", "what_it_supports": "Consensus overview of structure, function, innervation, capacity, and major diseases; used only as a secondary map onto primary anatomical and urological sources.", "url_status": "live" }, { "id": "wikidata-q9382", "title": "urinary bladder (Q9382)", "url": "https://www.wikidata.org/wiki/Q9382", "what_it_supports": "Stable public identifier and crosswalks to FMA, UBERON, MeSH, and SNOMED.", "url_status": "live" }, { "id": "mesh-d001743", "title": "Urinary Bladder (MeSH D001743)", "url": "https://www.ncbi.nlm.nih.gov/mesh/68001743", "what_it_supports": "NLM controlled heading for the organ and the bibliographic cluster of bladder research.", "url_status": "live" }, { "id": "eau-guidelines", "title": "EAU Guidelines (Non-muscle-invasive Bladder Cancer; Muscle-invasive and Metastatic Bladder Cancer; Neuro-Urology; Non-neurogenic Female LUTS)", "url": "https://uroweb.org/guidelines", "what_it_supports": "How the living organ is investigated and treated in contemporary urology: cystoscopy, BCG, cystectomy, urodynamics, and neurogenic-bladder pressure limits.", "url_status": "live" }, { "id": "moore-clin-anat", "title": "Clinically Oriented Anatomy", "url": "", "what_it_supports": "Sex-specific relations, catheterization landmarks, rupture patterns (intra- versus extraperitoneal), and distinction from adjacent pelvic viscera." }, { "id": "wikipedia-en", "title": "Wikipedia: Bladder", "url": "https://en.wikipedia.org/wiki/Bladder", "url_status": "live", "what_it_supports": "general description of the item", "checked_by": "wikidata-api sitelink" } ], "structure": { "bundles": [ { "id": "bladder-identity-and-boundaries", "name": "Bladder identity and boundaries", "description": "Establishes which organ is being modelled and where its urinary and tissue boundaries lie.", "rationale": "A urinary reservoir may be native, altered or replaced, and those identities must not be conflated.", "layers": [ { "id": "organ-identification", "name": "Organ identification", "description": "Identifies the bladder within its host and anatomical context.", "findings": [ { "id": "identified-urinary-reservoir", "name": "Identified urinary reservoir", "description": "Records evidence that the structure is a urinary bladder rather than another fluid-filled structure.", "questions": [ { "text": "Which host, species and developmental stage does this bladder belong to?", "kind": "definition", "id": "identified-urinary-reservoir-q01" }, { "text": "What anatomical, imaging or operative evidence establishes this structure as the bladder?", "kind": "provenance", "id": "identified-urinary-reservoir-q02" } ] } ] }, { "id": "native-and-altered-boundaries", "name": "Native and altered boundaries", "description": "Locates the bladder's connections and accounts for surgical changes.", "findings": [ { "id": "urinary-and-tissue-interfaces", "name": "Urinary and tissue interfaces", "description": "Records ureteral entries, the outlet and any reconstructed tissue or drainage connection.", "questions": [ { "text": "Where do the ureters and outlet meet the bladder, and which observed abnormalities cross those boundaries?", "kind": "boundary", "id": "urinary-and-tissue-interfaces-q01" }, { "text": "What native tissue remains, and what reconstruction or augmentation is documented?", "kind": "provenance", "id": "urinary-and-tissue-interfaces-q02" } ] } ] } ] }, { "id": "bladder-wall-and-lumen", "name": "Bladder wall and lumen", "description": "Describes the bladder's tissue envelope and findings within its cavity.", "rationale": "Wall integrity and luminal abnormalities can affect storage, emptying and the suitability of an intervention.", "layers": [ { "id": "wall-and-lining", "name": "Wall and lining", "description": "Records local tissue observations with their assessment conditions.", "findings": [ { "id": "wall-integrity-and-local-lesions", "name": "Wall integrity and local lesions", "description": "Separates observed wall or lining changes from their suspected causes.", "questions": [ { "text": "What wall or lining changes are observed, at which bladder location and by which method?", "kind": "measurement", "id": "wall-integrity-and-local-lesions-q01" }, { "text": "What filling state and prior procedures affect interpretation of these observations?", "kind": "provenance", "id": "wall-integrity-and-local-lesions-q02" }, { "text": "Is a finding confined to the bladder or documented to extend into neighbouring tissue?", "kind": "boundary", "id": "wall-integrity-and-local-lesions-q03" } ] } ] }, { "id": "luminal-contents", "name": "Luminal contents", "description": "Distinguishes urine from other material or devices occupying the lumen.", "findings": [ { "id": "non-urine-luminal-findings", "name": "Non-urine luminal findings", "description": "Records stones, clots, debris, foreign material or device components as separately evidenced findings.", "questions": [ { "text": "What material or device is observed within the bladder, and how was its identity established?", "kind": "provenance", "id": "non-urine-luminal-findings-q01" }, { "text": "What size, mobility, attachment or relationship to the outlet is documented?", "kind": "measurement", "id": "non-urine-luminal-findings-q02" } ] } ] } ] }, { "id": "urine-storage", "name": "Urine storage", "description": "Represents filling volume, storage mechanics and sensation.", "rationale": "A bladder's ability to hold urine cannot be judged from its size alone.", "layers": [ { "id": "filling-and-capacity", "name": "Filling and capacity", "description": "Distinguishes a momentary volume from an assessed storage endpoint.", "findings": [ { "id": "volume-and-capacity-context", "name": "Volume and capacity context", "description": "Records volume measurements and the conditions defining any capacity estimate.", "questions": [ { "text": "What volume was measured, when and by which method?", "kind": "measurement", "id": "volume-and-capacity-context-q01" }, { "text": "If capacity is reported, what endpoint and natural or artificial filling conditions define it?", "kind": "definition", "id": "volume-and-capacity-context-q02" } ] } ] }, { "id": "storage-mechanics-and-sensation", "name": "Storage mechanics and sensation", "description": "Relates pressure and detrusor behaviour to the filling experience.", "findings": [ { "id": "filling-pressure-response", "name": "Filling pressure response", "description": "Records storage pressure, compliance and associated sensations without assuming they agree.", "questions": [ { "text": "What pressure-volume response and detrusor activity were recorded during filling, and how were they measured?", "kind": "measurement", "id": "filling-pressure-response-q01" }, { "text": "What sensation, urgency or pain was reported at the corresponding filling stages, or was reporting not possible?", "kind": "measurement", "id": "filling-pressure-response-q02" } ] } ] } ] }, { "id": "bladder-emptying", "name": "Bladder emptying", "description": "Records how urine leaves the bladder and how completely it empties.", "rationale": "Emptying depends on bladder contraction, outlet conditions and any assisted drainage, which require separate evidence.", "layers": [ { "id": "voiding-coordination", "name": "Voiding coordination", "description": "Connects bladder activity with flow and the outlet interface.", "findings": [ { "id": "contraction-and-outflow", "name": "Contraction and outflow", "description": "Records the observed relationship between contraction and urine outflow without inferring a cause from flow alone.", "questions": [ { "text": "What detrusor pressure, urine flow and assistance were documented during the same emptying episode?", "kind": "measurement", "id": "contraction-and-outflow-q01" }, { "text": "What evidence distinguishes impaired bladder contraction from resistance or coordination problems at the outlet?", "kind": "boundary", "id": "contraction-and-outflow-q02" } ] } ] }, { "id": "emptying-outcome", "name": "Emptying outcome", "description": "Records residual urine and the mode by which emptying occurred.", "findings": [ { "id": "residual-and-drainage-mode", "name": "Residual and drainage mode", "description": "Keeps spontaneous voiding outcomes distinct from device-assisted drainage outcomes.", "questions": [ { "text": "How much urine remained after voiding, measured by which method and after what interval?", "kind": "measurement", "id": "residual-and-drainage-mode-q01" }, { "text": "Was emptying spontaneous, assisted or catheter-mediated, and what limitations does that place on judging native function?", "kind": "boundary", "id": "residual-and-drainage-mode-q02" } ] } ] } ] }, { "id": "bladder-assessment-and-action", "name": "Bladder assessment and action", "description": "Connects bladder-specific evidence, uncertainty and proposed interventions.", "rationale": "Urinary symptoms may arise outside the bladder, and bladder-directed actions need a documented indication and accountable decision.", "layers": [ { "id": "symptom-and-diagnosis-attribution", "name": "Symptom and diagnosis attribution", "description": "Separates local observations, reported symptoms and confirmed diagnoses.", "findings": [ { "id": "evidence-for-bladder-origin", "name": "Evidence for bladder origin", "description": "Records why a concern is attributed to the bladder and what competing explanations remain.", "questions": [ { "text": "What evidence supports a bladder origin for pain, bleeding, urgency, leakage or suspected infection?", "kind": "provenance", "id": "evidence-for-bladder-origin-q01" }, { "text": "Which possible sources in the kidneys, ureters, urethra or neighbouring organs remain unresolved?", "kind": "boundary", "id": "evidence-for-bladder-origin-q02" } ] } ] }, { "id": "intervention-and-reassessment", "name": "Intervention and reassessment", "description": "Tracks the basis, authority and observed outcome of bladder-directed action.", "findings": [ { "id": "justified-bladder-directed-action", "name": "Justified bladder-directed action", "description": "Records proposed or completed assessment, drainage or treatment and the evidence needed to evaluate its result.", "questions": [ { "text": "What bladder-specific concern motivates the proposed action, and what prerequisites and clinical authority are documented?", "kind": "action", "id": "justified-bladder-directed-action-q01" }, { "text": "Which bladder volume, pressure, residual, tissue finding or symptom will be reassessed to determine the outcome?", "kind": "action", "id": "justified-bladder-directed-action-q02" }, { "text": "What device placement, sampling route or procedure details must accompany the resulting observations?", "kind": "provenance", "id": "justified-bladder-directed-action-q03" } ] } ] } ] }, { "id": "evidence-and-external-alignment", "name": "Evidence and external alignment", "description": "What the world already says about this thing, gathered so the model can be checked against it.", "rationale": "A model that cannot be lined up against existing standards, identifiers and practice cannot be adopted by anyone who already uses them.", "layers": [ { "id": "reported-evidence", "name": "Reported evidence", "description": "Findings from the breadth pass, kept separate from the structural claims.", "findings": [ { "id": "evidence-kinds", "name": "Kinds and varieties", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ "Adult male urinary bladder (base resting on prostate; inferolateral relations to the pelvic floor and rectum)", "Adult female urinary bladder (base related to the anterior vagina and uterine cervix; shorter urethra)", "Infant and young-child bladder (still largely abdominal when empty; descends into the pelvis with growth)", "Fetal bladder (endodermal urogenital-sinus derivative in continuity with the allantois/urachus)", "Bladder exstrophy and cloacal-exstrophy complex (failed abdominal-wall and pelvic closure)", "Orthotopic neobladder (ileal or colonic continent reservoir constructed after cystectomy)", "Neurogenic bladder as a clinical organ-state (storage or emptying failure after spinal, brain, or peripheral-nerve injury)", "Veterinary mammalian urinary bladder (same viscus in domestic species; common clinical object in dogs and cats)" ], "questions": [ { "id": "evidence-kinds-q01", "text": "Which of these kinds and varieties hold for the sense of urinary bladder this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-identifiers", "name": "Identifiers and schemes", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ { "scheme": "Wikidata", "value_or_pattern": "Q9382", "note": "Item for the anatomical organ urinary bladder / vesica urinaria." }, { "scheme": "Foundational Model of Anatomy (FMA)", "value_or_pattern": "15900", "note": "FMAID for urinary bladder." }, { "scheme": "UBERON", "value_or_pattern": "UBERON:0001255", "note": "Multi-species anatomy ontology class urinary bladder." }, { "scheme": "MeSH", "value_or_pattern": "D001743", "note": "NLM heading Urinary Bladder; Tree A05.810.453." }, { "scheme": "SNOMED CT", "value_or_pattern": "89837001", "note": "Urinary bladder structure (body structure)." }, { "scheme": "Terminologia Anatomica (TA2)", "value_or_pattern": "A08.3.01.001", "note": "vesica urinaria / urinary bladder." }, { "scheme": "ICD-O / ICD-10 topography", "value_or_pattern": "C67._", "note": "Malignant neoplasm of bladder; fourth digit sites the wall (C67.0 trigone through C67.9 unspecified)." }, { "scheme": "NCI Thesaurus", "value_or_pattern": "C12414", "note": "Urinary Bladder; used in oncology data models." } ], "questions": [ { "id": "evidence-identifiers-q01", "text": "Which of these identifiers and schemes hold for the sense of urinary bladder this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-standards-and-regulation", "name": "Standards and regulation", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ "Terminologia Anatomica 2 - FIPAT / International Federation of Associations of Anatomists (nomenclature of the organ and its parts).", "SNOMED CT - SNOMED International (clinical recording of the organ, procedures, and findings).", "ICD-10 / ICD-11 - World Health Organization (diseases and topography of the bladder, including N30-N32 and C67 / equivalent ICD-11 codes).", "EAU Guidelines on bladder cancer and neuro-urology - European Association of Urology (investigation and treatment standards used across Europe and widely cited globally).", "AUA / SUFU guidelines (overactive bladder, microhematuria, interstitial cystitis/BPS) - American Urological Association.", "QUANTEC / ICRP organ-at-risk dose constraints for bladder in pelvic radiotherapy - AAPM QUANTEC group and International Commission on Radiological Protection.", "ISO 20696 (sterile urethral catheters) and related urine-collection device standards - International Organization for Standardization; national adoptions (e.g. EN ISO) and FDA/EMA device regulation for catheters, stents, and intravesical delivery systems." ], "questions": [ { "id": "evidence-standards-and-regulation-q01", "text": "Which of these standards and regulation hold for the sense of urinary bladder this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-real-world-use", "name": "Real-world use", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ "Physiologic urine storage between voids and coordinated emptying in every mammal with a vesical reservoir.", "Office and theatre cystoscopy for hematuria, tumour surveillance, and transurethral resection.", "Urethral or suprapubic catheterization to drain or irrigate the reservoir.", "Urodynamic filling and pressure-flow studies to classify incontinence, obstruction, and neurogenic dysfunction.", "Intravesical drug or BCG instillation, using the organ as a closed treatment chamber.", "Ultrasound, CT cystography, and MRI for volume, wall, rupture, and staging.", "Organ-at-risk contouring and dose tracking in prostate, cervix, and rectal radiotherapy.", "Veterinary cystocentesis, stones, and transitional-cell tumours, especially in dogs." ], "questions": [ { "id": "evidence-real-world-use-q01", "text": "Which of these real-world use hold for the sense of urinary bladder this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-measurements", "name": "Typical measurements", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ { "quantity": "Functional (cystometric) capacity in an adult", "typical_range": "400-600", "unit": "mL" }, { "quantity": "Pediatric expected capacity (commonly (age in years + 2) × 30)", "typical_range": "age-dependent; e.g. ~150 at 3 years, ~300 at 8 years", "unit": "mL" }, { "quantity": "Sonographic wall thickness (moderately filled)", "typical_range": "about 2-4 (often called abnormal if >5 empty or >3 well filled)", "unit": "mm" }, { "quantity": "Post-void residual in an unobstructed adult", "typical_range": "<50 (many labs treat <100 as acceptable)", "unit": "mL" }, { "quantity": "Volume at first desire to void", "typical_range": "150-250", "unit": "mL" }, { "quantity": "Detrusor leak-point pressure (upper-tract safety threshold in neurogenic bladder)", "typical_range": "keep below 40", "unit": "cmH2O" }, { "quantity": "Daytime voiding frequency in a healthy adult", "typical_range": "4-8", "unit": "voids per waking day" } ], "questions": [ { "id": "evidence-measurements-q01", "text": "Which of these typical measurements hold for the sense of urinary bladder this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-failure-modes-and-hazards", "name": "Failure modes and hazards", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ "Acute bacterial cystitis and, if high-pressure or refluxing, ascending pyelonephritis.", "Urothelial (transitional-cell) carcinoma of the bladder wall; squamous-cell carcinoma where Schistosoma haematobium is endemic.", "Urinary retention, overflow incontinence, and chronic high-pressure storage that can injure the kidneys.", "Overactive bladder / detrusor overactivity and stress incontinence from sphincter or support failure.", "Bladder stones, diverticula, and trabeculation after prolonged outlet obstruction.", "Intraperitoneal or extraperitoneal rupture after pelvic fracture or overdistension.", "Vesicovaginal or vesicoenteric fistula after obstructed labour, surgery, or radiation.", "Hemorrhagic or radiation cystitis (e.g. cyclophosphamide, pelvic radiotherapy) and bladder pain syndrome / interstitial cystitis." ], "questions": [ { "id": "evidence-failure-modes-and-hazards-q01", "text": "Which of these failure modes and hazards hold for the sense of urinary bladder this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-regional-variation", "name": "Regional variation", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ "English 'bladder' or 'urinary bladder' versus Latin vesica urinaria (TA), German Harnblase, French vessie, and many clinical synonyms such as vesical.", "Cancer histology and public-health burden: squamous-cell carcinoma still prominent in S. haematobium belts (parts of Africa and the Middle East); urothelial carcinoma dominates in high-income tobacco-associated populations.", "Infant bladder position and paediatric urodynamic reference ranges differ from adult pelvic practice; exstrophy care is concentrated in a few specialist centres.", "Catheterisation customs, continence surgery, and BCG availability vary by health-system resources; some traditional medical systems name the organ within different viscera schemes (e.g. Chinese 膀胱 pangguang)." ], "questions": [ { "id": "evidence-regional-variation-q01", "text": "Which of these regional variation hold for the sense of urinary bladder this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-neighbours", "name": "Neighbouring kinds and how to tell them apart", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ { "name": "Gallbladder", "difference": "Different viscus: right-upper-quadrant bile reservoir versus pelvic urine reservoir; distinguished by location, contents, and duct connection (cystic duct versus ureters/urethra)." }, { "name": "Prostate", "difference": "In the male the bladder base sits on the prostate; DRE, PSA, and zonal MRI identify prostate, while urine-filled lumen and ureteric orifices identify bladder." }, { "name": "Uterus (and gravid uterus)", "difference": "Uterus lies behind and above the female bladder; endometrium, pregnancy test, and a thick myometrial wall on ultrasound separate it from the thin-walled urine-filled bladder." }, { "name": "Urachal remnant / urachal cyst", "difference": "Midline remnant from bladder dome to umbilicus; a patent tract or cyst along that line, not the vesical lumen itself." }, { "name": "Distended rectum or fluid-filled bowel loop", "difference": "On ultrasound or CT, bowel has haustra or faecal content and a mesenteric connection; bladder is midline, urine-filled, and continuous with urethra and ureteric jets." }, { "name": "Cystic ovarian or adnexal mass", "difference": "Lateral pelvic, ovarian vessels or follicles, and no ureteric jets; bladder is midline and catheterisable." }, { "name": "Urethra (including urethral diverticulum)", "difference": "Conduit distal to the bladder neck; voiding cystourethrography or urethroscopy shows the neck as the boundary." } ], "questions": [ { "id": "evidence-neighbours-q01", "text": "Which of these neighbouring kinds and how to tell them apart hold for the sense of urinary bladder this model covers, and on what evidence?", "kind": "provenance" } ] } ] } ] } ] }, "openQuestions": [ "Should the initial model cover human urinary bladders only, or which species-specific anatomical variants must it support?", "Which reference standards and assessment protocols should govern interpretation of capacity, compliance, storage pressure and residual volume for each population?", "At what degree of augmentation or reconstruction should a urinary reservoir receive a separate linked model rather than remain a configuration of this entry?", "Which minimum evidence is required to attribute urinary symptoms, infection or bleeding to the bladder rather than another part of the urinary tract?", "Which bladder findings require escalation under the intended deployment's clinical protocols, and which actions may the agent initiate versus only record or recommend for review?" ], "statistics": { "bundles": 6, "layers": 11, "findings": 18, "questions": 30 } }