Some new insights into bladder function in infancy

Yeung, Chung Kwong; Godley, Margaret L.; Ransley, Philip G.; Duffy, P.G.; Chen, C.N.

doi:10.1111/j.1464-410x.1995.tb07682.x

Cited by 166 publications

(97 citation statements)

References 8 publications

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“…Voiding detrusor pressure is reported to be higher in male infants than in elder children or adults, with normalization of high pressure voiding with maturation in accordance with an increase in bladder capacity (4, 14, 18). Yeung et al have suggested that a greater resistance to urine outflow causes high pressure voiding in infants (18). This research suggested that the PGE2 level was associated with OAB symptom in boys with LUTO as well as adults.…”

Section: Referencesmentioning

confidence: 63%

A higher level of prostaglandin E2 in the urinary bladder in young boys and boys with lower urinary tract obstruction

et al. 2009

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We conducted two studies to examine the hypothesis that lower urinary tract obstruction induces excessive production of prostaglandin E2 (PGE2) in the bladder in young boys, with consequent overactive bladder (OAB) symptoms. The subjects were boys aged less than 15 years old who were scheduled to undergo surgery in our department from October 2006 to March 2008. In study 1 (n = 25), the patients were divided into two groups based on the presence or absence of lower urinary tract obstruction. In study 2 (n = 38), the patients were classified by age. The PGE2 level in the bladder was determined by washing with saline before the operation and urinary symptoms were evaluated using the Pediatric Lower Urinary Tract Scoring System. In study 1, the PGE2 level in the bladder of patients with lower urinary tract obstruction was higher than in those without obstruction (49.1 ± 37.4 vs. 21.5 ± 10.1 pg/mL, P = 0.0475). In study 2, the PGE2 level in the bladder was negatively correlated with age (r = −0.379, P = 0.0207). A higher level of PGE2 is found in boys with bladder outlet obstruction due to urethral stricture and in younger boys, and this elevated level of PGE2 may induce OAB symptoms.Lower urinary tract obstruction (LUTO) in boys can induce daytime incontinence and pollakisuria (10). In adults, these symptoms are referred to as overactive bladder (OAB) syndrome. Based on studies in adult human and in animal models, activation of capsaicin-sensitive fibers (C-fibers) is thought to be one etiology of OAB syndrome induced by LUTO. Several substances derived from the bladder have been associated with reactivation of C-fibers, including prostaglandin E2 (PGE2). PGE2 has an important role in regulation of lower urinary tract function (2), and its overexpression in the bladder stimulates the micturition reflex through activation of C-fibers in a rat model (9). Moreover, instillation of PGE2 into the bladder of adults induces detrusor overactivity and OAB symptoms (13). The relationship of LUTO and excessive production of PGE2 in animal models and adult human has not been clarified in children, as far as we are aware. For many boys with LUTO, a voiding cystourethrogram or urethrocystoscopy under general anesthesia is required to diagnose the extent of LUTO. However, these examinations are invasive for young boys and do not always allow clarification of the degree of LUTO, which makes it difficult to determine whether an operation should be performed. Consequently, new methods of diagnosis of LUTO in boys are required. Also, the voiding detrusor pressure is reported to be higher in male infants than in older children or adults (4, 14, 18), and excessive production of PGE2 in the urinary bladder in young boys may be induced by overdistention of the bladder wall, as well as by LUTO. To address these issues, we conducted two studies to examine the hypothesis that LUTO induces higher levels of PGE2 in the bladder in young boys, with conse-

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Section: Referencesmentioning

confidence: 63%

A higher level of prostaglandin E2 in the urinary bladder in young boys and boys with lower urinary tract obstruction

et al. 2009

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“…Multiple symptoms like frequency, urgency, urge incontinence, daytime wetting can be clues to underlying dysfunction. [1][2][3][4][5][6][7][8][9] Vincent's Curtsy (Figure 1) is a typical posturing in female children, who squat with heels on their perineum to manually overcome urgency. Eliciting a detailed history is essential to identify underlying voiding dysfunction in children with UTI.…”

Section: Discussionmentioning

confidence: 99%

“…Voiding dysfunction is one of the leading causes of UTI in children. [1][2][3][4][5] Voiding dysfunction is defined as any disturbance in bladder filling or voiding after toilet training. It is seen in children without anatomical or neurological problems.…”

Section: Introductionmentioning

confidence: 99%

Voiding dysfunction in children with culture positive urinary tract infection

Ramalingam

James

Babu

et al. 2015

Int J Contemp Pediatr

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“…Debido a esta relación entre la vejiga y el intestino, los trastornos concomitantes del vaciado intestinal y vesical se han etiquetado como DVI. Este es un término general que se subdivide en disfunción del tracto urinario inferior (LUTD) en niños mayores de 5 años y disfunción intestinal en mayores de 4 años, en niños que no tienen ninguna anormalidad neurológica identificada (19).…”

Section: Síndromes Clínicos Relacionados Con La Disfunción Miccionalunclassified

Evaluación y tratamiento del niño con síntomas del tracto urinario inferior (LUTS)

Guerrero-Tinoco

Cano-Martínez

Vanegas-Ruiz

2018

iatreia

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RESUMENLa disfunción miccional es un trastorno del llenado o vaciado de la vejiga en niños sin alteraciones neurológicas o anatómicas. Los síntomas del tracto urinario inferior (LUTS, por la sigla en inglés de Lower urinary tract symptoms) son un motivo frecuente de consulta con el pediatra, el nefrólogo o el urólogo pediatra, e incluso con el neurólogo y el psicólogo infantil. Se le considera una enfermedad relativamente benigna lo que en ocasiones genera desinterés entre médicos y familiares y lleva a consultas tardías e interpretación inadecuada de los síntomas. Manifestaciones como urgencia, incontinencia, enuresis, goteo posmiccional, infecciones urinarias, vulvovaginitis recurrente y constipación, en un niño sin enfermedad neurológica, deben hacer pensar al médico en disfunción miccional para enfocar oportunamente el diagnóstico, restablecer la calidad de vida del paciente, evitar las infecciones urinarias y el daño renal subsecuente e irreversible secundario a un diagnóstico tardío. Las recomendaciones actuales hacen énfasis en un enfoque menos invasivo, tratamiento conservador, manejo de la constipación y reentrenamiento vesical. Este artículo discute la evaluación, el diagnóstico y el tratamiento correctos de niños con LUTS.

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Some new insights into bladder function in infancy

Cited by 166 publications

References 8 publications

A higher level of prostaglandin E2 in the urinary bladder in young boys and boys with lower urinary tract obstruction

A higher level of prostaglandin E2 in the urinary bladder in young boys and boys with lower urinary tract obstruction

Voiding dysfunction in children with culture positive urinary tract infection

Evaluación y tratamiento del niño con síntomas del tracto urinario inferior (LUTS)

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