Is 40 cm H<sub>2</sub>O detrusor leak point pressure cut‐off reliable for upper urinary tract protection in children with myelodysplasia?

Tarcan, Tufan; Sekerci, Cagri Akin; Akbal, Cem; Tınay, İlker; Tanıdır, Yılören; Şahan, Ahmet; Şahin, Bahadır; Top, Tuncay; Şimşěk, Ferruh

doi:10.1002/nau.23017

Cited by 29 publications

(33 citation statements)

References 25 publications

(50 reference statements)

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“…An increase or new-onset HN or FUTI prompted an additional VCUG and urodynamic evaluation or fluoroscopic urodynamic evaluation. [3][4][5][6] Antibiotic prophylaxis were initiated after an episode of febrile UTI.…”

Section: Management and Follow-upmentioning

confidence: 99%

The effect of intradetrusor botulinum neurotoxin type A on urinary NGF, TGF BETA-1, TIMP-2 levels in children with neurogenic detrusor overactivity due to myelodysplasia

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Sekerci

Isbilen-Basok³

et al. 2017

Neurourology and Urodynamics

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Section: Management and Follow-upmentioning

confidence: 99%

The effect of intradetrusor botulinum neurotoxin type A on urinary NGF, TGF BETA-1, TIMP-2 levels in children with neurogenic detrusor overactivity due to myelodysplasia

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Isbilen-Basok³

et al. 2017

Neurourology and Urodynamics

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“…Myelomeningocele (MMC) is the most frequent presentation of myelodysplasias, a major cause of neurogenic bladder among children. The severity of MMC neurologic lesions vary, and urologic implications are the main cause of death in approximately 18% of patients . Overall, 30‐40% of patients have some degree of renal impairment associated with urinary tract infection (UTI) and may affect up to 100% of patients with detrusor sphincter dyssynergia (DSD) …”

Section: Introductionmentioning

confidence: 99%

Can dynamic ultrasonography replace urodynamics in the follow‐up of patients with myelomeningocele? A prospective concurrent study

Bortolini

Lucena

Batezini

et al. 2018

Neurourology and Urodynamics

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Aims: To evaluate the accuracy of dynamic ultrasonography (DUS), as a feasible alternative diagnostic method to identify detrusor overactivity (DO) in patients with neurogenic bladder. Methods: We performed concurrent analysis of 81 pairs of urodynamic study (UDS) and DUS, in 63 patients with myelomeningocele (MMC), from June 2014 to February 2017. The assessment focused on bladder behavior during the filling phase, DO evaluation, DO with leakage, compliance, and maximum cystometric capacity (MCC). Results: Patient age ranged from 3 months to 34 years (median, 84 months); 47.6% were male. Overall, 9.5% of patients had chronic kidney disease, 20.6% had recurrent urinary tract infection, 19.05% had vesicoureteral reflux, and 69.8% had constipation. Anticholinergic therapy was used by 41.3% of patients. DO was observed in 45.67% of patients and DO with leakage in 42.6%. Mean bladder compliance was 10.39 mL/ cmH 2 O and normal MCC was 56.79%. DUS had 91.89% sensitivity in identifying DO, 88.64% specificity, 87.18% positive predictive value, 92.86% negative predictive value, and 90.12% accuracy, with a kappa coefficient of 0.8 (P < 0.001). Conclusion: MMC follow-up is essential because urinary parameters can change during patient growth. The standard examination is invasive and has related complications, making noninvasive evaluation a desirable alternative, like DUS. Our data suggest that DO and MCC can be evaluated using DUS in patients with MMC. UDS should be performed in patients with abnormal findings on ultrasound evaluation or those with worsening of urinary tract function. K E Y W O R D S dynamic ultrasonography, myelomeningocele, pediatric neurogenic bladder, spinal dysraphism

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“…Values higher than 40 cm H 2 O are proven to be a major contribution to UUTD [31]. Even values between 20 and 40 cm H 2 O are shown to be more sensitive for predicting UUTD [32]. In our study, the DLPP of children above 20 cm H 2 O is related with UUTD which means determining the bladder urodynamic characteristics may be important in deciding emphasis of the treatment.…”

Section: Discussionmentioning

confidence: 64%

The role of occult spinal malformation and upper urinary tract deterioration in children with intractable voiding dysfunction

Tanıdır

Şener

Sekerci

et al. 2017

MMJ

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Objectives: To evaluate the presence of upper urinary tract deterioration (UUTD) and accompanying pathologies in children treated with the diagnosis of non-neurogenic bladder-sphincter dysfunction (NNBSD). Patients and Methods:We retrospectively reviewed the medical records of 316 consecutive patients with NNBSD who were treated. All cohort were grouped into two: Group I (Treatment success; n=284), Group II (Treatment failure with any form of occult spinal pathology; n=32). Thirty-four children with treatment-failure and normal magnetic resonance imaging (MRI) findings were excluded. Groups were compared for pre-and posttreatment pediatric lower urinary tract symptom score (PLUTSS), presence of UUTD and urodynamic findings. Results:The mean PLUTSS was significantly less in Group I compared with Group II at pre-treatment and 3 months thereafter the initial treatment (12.20 ± 5.90 and 5.20 ± 4.90 vs 20.3 ± 2.14 and 18 ± 3.4, respectively p<0.01). The mean cystometric capacities and detrusor leak point pressure (DLPP) of Group II prior to initial treatment and after 6 months of the untethering surgery were found to be 194, 267 mL and 28, 12cm H2O, respectively (p<0.05). Presence of UUTD was significantly correlated with DLPP >20 cm H2O and presence of vesicoureteral reflux (VUR).Conclusion: UUTD in NNBSD is more common in children with occult spinal pathology, than in those without.Keywords: Non-neuropathic bladder sphincter dysfunction, Upper urinary tract deterioration, Symptom score ÖZ Amaç: Nörojenik olmayan mesane-sfinkter fonksiyon bozukluğu (NOMSFB) tanısıyla tedavi edilen çocuklarda üst üriner sistem hasarı (ÜÜSH) ve eşlik eden patolojilerin araştırılmasıdır. Hastalar ve Yöntemler:NOMSFB nedeniyle kliniğimizde tedavi edilen 316 çocuğun tıbbi kayıtları retrospektif olarak incelendi. Çocuklar, tedavi yanıtına ve magnetic resonans görüntüleme (MRG) bulgularına göre iki gruba ayrıldılar: Grup I (Tedaviye yanıt verenler; n=284) ile Grup II (Tedaviye dirençli olup, lomber MRG'sinde gizli spinal disrafizm bulgusu olanlar; n=32). Tedaviye dirençli olup lomber MRG'sinde patoloji saptanmayan 34 çocuk çalışma dışı bırakıldı. Gruplar tedavi öncesi ve sonrası semptom skoru (SS), ÜÜSH ile ürodinami bulguları açısından karşılaştırıldı. Bulgular:Tedavi öncesi dönemde ve tedavi başladıktan üç ay sonra, Grup I'in ortalama SS'si Grup II'ye göre anlamlı olarak düşük saptandı (sırasıyla 12,20 ± 5,90 ve 5,20 ± 4,90 karşın 20,3 ± 2,14 ve 18 ± 3,4; p<0.01). Grup II'nin başlangıç tedavisi öncesi ortalama sistometrik kapasitesi ve detrüsör kaçırma anı basıncı (DKAB) sırasıyla 194 ml ve 28 cm H2O olarak saptandı. Grup II'nin gergin omurilik onarımını takip eden altıncı ayda ortalama sistometrik kapasite ve ortalama DKAB sırasıyla 267 ml ve 12 cmH2O olarak saptandı. ÜÜSH varlığı ile DKAB'ın 20 cmH2O üzeri olması ve vezikoüreteral reflü varlığı arasında anlamlı ilişki bulundu.Sonuç: NOMSFB'da ÜÜSH, gizli spinal disrafizm varlığında daha sık görülür.Anahtar kelimeler: Nörojenik olmayan mesane-sfinkter fonksiyon bozukluğu, Üst ü...

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Is 40 cm H₂O detrusor leak point pressure cut‐off reliable for upper urinary tract protection in children with myelodysplasia?

Cited by 29 publications

References 25 publications

The effect of intradetrusor botulinum neurotoxin type A on urinary NGF, TGF BETA-1, TIMP-2 levels in children with neurogenic detrusor overactivity due to myelodysplasia

The effect of intradetrusor botulinum neurotoxin type A on urinary NGF, TGF BETA-1, TIMP-2 levels in children with neurogenic detrusor overactivity due to myelodysplasia

Can dynamic ultrasonography replace urodynamics in the follow‐up of patients with myelomeningocele? A prospective concurrent study

The role of occult spinal malformation and upper urinary tract deterioration in children with intractable voiding dysfunction

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Is 40 cm H2O detrusor leak point pressure cut‐off reliable for upper urinary tract protection in children with myelodysplasia?

Cited by 29 publications

References 25 publications

The effect of intradetrusor botulinum neurotoxin type A on urinary NGF, TGF BETA-1, TIMP-2 levels in children with neurogenic detrusor overactivity due to myelodysplasia

The effect of intradetrusor botulinum neurotoxin type A on urinary NGF, TGF BETA-1, TIMP-2 levels in children with neurogenic detrusor overactivity due to myelodysplasia

Can dynamic ultrasonography replace urodynamics in the follow‐up of patients with myelomeningocele? A prospective concurrent study

The role of occult spinal malformation and upper urinary tract deterioration in children with intractable voiding dysfunction

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Is 40 cm H₂O detrusor leak point pressure cut‐off reliable for upper urinary tract protection in children with myelodysplasia?