Prevalence of Urinary Tract Infection and Vesicoureteral Reflux in Children with Lower Urinary Tract Dysfunction

Batavia, Jason P. Van; Ahn, Jennifer; Fast, Angela M.; Combs, Andrew J.; Glassberg, Kenneth I.

doi:10.1016/j.juro.2013.02.016

Cited by 37 publications

(20 citation statements)

References 8 publications

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“…Clinical studies have shown that 30 -40% of patients (namely children) with bladder dysfunction also exhibit vesicoureteral reflux (VUR) (29,30). In these patients, the risk of developing chronic kidney disease and reflux nephropathy is greatly increased above those with either VUR or bladder dysfunction alone (3).…”

Section: Discussionmentioning

confidence: 99%

Fgfr2 is integral for bladder mesenchyme patterning and function

Walker

Ikeda

Zabbarova

et al. 2015

American Journal of Physiology-Renal Physiology

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BMϪ/Ϫ bladders exhibited higher levels of Cdo and Boc, hedgehog coreceptors that enhance sensitivity to Shh, compared with control bladders. In conclusion, loss of Fgfr2 in the bladder mesenchyme leads to abnormal bladder morphology and decreased compliance and contractility. bladder development; bladder dysfunction; fibroblast growth factor receptor 2 MURINE BLADDER DEVELOPMENT begins at embryonic day (E)10.5, when the cloaca is subdivided into the urogenital sinus ventrally and the anal canal dorsally (5). At E13.5, the bladder urothelium induces the surrounding mesenchyme to begin differentiating into the inner lamina propria and outer smooth muscle layers (5). Secretion of sonic hedgehog (Shh) by the bladder urothelium is a major inducer for mesenchymal patterning (5,7,8,20). The E16.5 bladder begins receiving urine from the newly developed metanephric nephrons.

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Section: Discussionmentioning

confidence: 99%

Fgfr2 is integral for bladder mesenchyme patterning and function

Walker

Ikeda

Zabbarova

et al. 2015

American Journal of Physiology-Renal Physiology

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“…Additional steps should be taken to review the presence of UTI risk factors described above. Many patients with rUTI have underlying bowel and/or bladder dysfunction, and rUTI may be the presenting sign of this condition [54]. Thus, the clinician evaluating a patient with rUTI should take a careful history of voiding and stooling behaviors.…”

Section: Recurrent Uti History and Physical Exammentioning

confidence: 99%

The diagnosis, evaluation and treatment of acute and recurrent pediatric urinary tract infections

Becknell

Schober

Korbel

et al. 2014

Expert Review of Anti-infective Therapy

105

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Urinary tract infection is one of the most common bacterial infections encountered by pediatricians. Currently, the diagnosis and management of acute urinary tract infection and recurrent urinary tract infection in children remains controversial. Recently published guidelines and large clinical trials have attempted to clarify UTI diagnostic and management strategies. In this manuscript, we review the diagnosis and management of acute and recurrent urinary tract infection in the pediatric population.

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“…Moreover, two of four children with a history of recurrent UTIs had increased PVR with RD. It has been shown that children with VD have decreased bladder emptying and increased PVR predisposing them to UTIs . The presence and degree of fecal loading on abdominal radiographs has been associated with the number of UTIs .…”

Section: Discussionmentioning

confidence: 99%

“…It has been shown that children with VD have decreased bladder emptying and increased PVR predisposing them to UTIs. 34 The presence and degree of fecal loading on abdominal radiographs has been associated with the number of UTIs. 35 Effective Figure 4 Intra-anal pressures with (solid line) and without (staggered line) (RD) at different quartiles of bladder filling and during voiding.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous urodynamic and anorectal manometry studies in children: insights into the relationship between the lower gastrointestinal and lower urinary tracts

Ambartsumyan

Siddiqui

Bauer

et al. 2016

Neurogastroenterology Motil

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Background Children with urinary incontinence (UI) have associated functional constipation (FC) and fecal incontinence (FI). The physiology between lower urinary tract (LUT) and anorectum in children has not been elucidated. Aims Observe the effect of rectal distention (RD) on LUT function, and bladder filling and voiding on anorectal function. Methods Children with voiding dysfunction referred to Boston Children’s Hospital were prospectively enrolled for combined urodynamic (UDS) and anorectal manometry (ARM). Anorectal and urodynamic parameters were simultaneously measured. Patients underwent 2 micturition cycles, 1st with rectal balloon deflated and 2nd with it inflated (RD). LUT and anorectal parameters were compared between cycles. Key Results 10 children (7 UI, 4 recurrent UTIs, 9 FC ± FI) were enrolled. Post void residual (PVR) increased (p=0.02) with RD. No differences were observed in percent of bladder filling to expected bladder capacity, sensation, and bladder compliance with and without RD. Bladder and abdominal pressures increased at voiding with RD (p<0.05). Intra-anal pressures decreased at voiding (p<0.05), at 25% (p=0.03) and 50% (p=0.06) of total volume of bladder filling. Conclusions & Inferences The PVR volume increased with RD. Stool in the rectum does not alter filling cystometric capacity but decreases the bladder’s ability to empty predisposing patients with fecal retention to UI and UTIs. Bladder and abdominal pressures increased during voiding demonstrating a physiological correlate of dysfunctional voiding. Intra-anal pressures decreased during bladder filling and voiding. This is the first time intra-anal relaxation during bladder filling and voiding has been described.

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Prevalence of Urinary Tract Infection and Vesicoureteral Reflux in Children with Lower Urinary Tract Dysfunction

Cited by 37 publications

References 8 publications

Fgfr2 is integral for bladder mesenchyme patterning and function

Fgfr2 is integral for bladder mesenchyme patterning and function

The diagnosis, evaluation and treatment of acute and recurrent pediatric urinary tract infections

Simultaneous urodynamic and anorectal manometry studies in children: insights into the relationship between the lower gastrointestinal and lower urinary tracts

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