Micturition Urodynamic Flow Studies in Children

Abstract

Voiding abnormalities are encountered frequently in pediatric patients. Symptoms of daytime incontinence, frequency and nocturnal enuresis in any combination may indicate underlying neurophysiologic detrusor imbalance. Incomplete evaluation of these symptoms can result in inappropriate medical therapy or even ineffective operations. Within the preceding 7 months 34 children with hard-core voiding abnormalities were evaluated with urodynamic techniques. Several categories of abnormal voiding patterns were identified, including the hyperactive external sphincter, uninhibited pediatric neurogenic bladder, detrusor hyperreflexia secondary to chronic cystitis, hyperactive external sphincter with hypotonic bladder and the hyperactive external sphincter with detrusor irritability. All patients received specific pharmacotherapy based on presenting signs and symptoms, and voiding pattern abnormality. Of the 24 patients who have been treated in this manner and were evaluated 83.5% have had complete remission of symptoms while on therapy, the remainder being improved but still having occasional symptoms. The technique and data demonstrate that children with hard-core voiding abnormalities can achieve rehabilitation with urodynamic assessment.

Urodynamics in enuretics I: Reservoir function

“…Urodynamically proven bladder instability has frequently bcen emphasimd as the possible cause of enuresis. Daytime urodynamic investigations have shown that bladder instability occurs in 29-90% of the investigated cases [Firlit et al, 1978;Kahn et al, 1984;Mahoney et al, 1977a,b;McGuire and Savastano, 1984;Palmtag et al, 1975); Webster et al,15)84a,b]. This broad spectrum of incidence in bladder instability may be explained by differences in the patient matcrial investigated and in investigational methods.…”

The usefulness of a minimal urodynamic evaluation and pelvic floor biofeedback in children with chronic voiding dysfunction

“…evaluation of non-neurogenic neurogenic bladder syndromes can result in inappropriate medical therapy or From 1994 to 1997, 120 children (38 boys and 82 girls, mean age 7.5 years, range 5-9) were retrospeceven ineCective surgery [1]. A standard urodynamic evaluation is not always well tolerated in children, tively evaluated by one urologist (C.P.)…”

Idiopathic Detrusor Sphincter Dyssynergia in Neurologically Normal Patients with Voiding Abnormalities

“…A dyscoordination between the detrusor and the activity of the pelvic floor was thought to be the cause of the condition. This possible mechanism was later evi denced by urodynamic investigations in children with enuresis and recurrent urinary tract infections [3][4][5], The present investigation was undertaken in order to describe the symptomatology and the clinical manifesta tions of the detrusor sphincter dyssynergia in patients without neurological manifestations. …”