Urodynamic outcomes of detethering in children: experience with 46 pediatric patients

Geyik, Murat; Geyik, Sırma; Şen, Haluk; Pusat, Serhat; Alptekin, Mehmet; Yılmaz, Ali Erdem; Nazik, Mert; Erkutlu, İbrahim

doi:10.1007/s00381-016-3053-y

Cited by 9 publications

(1 citation statement)

References 45 publications

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“…Some detected abnormal bladder functions, others reported changes in urodynamic variables following SCU, though parameters that were reported to undergo changes after SCU were not consistent between them. [2,4,5,[7][8][9][10][11][12][13][14][15][16][17] This was at least partially due to the fact that most studies compared single postoperative UDS performed in various postoperative periods with preoperative one, ignoring the possibility of developing bladder function in children. Thus, inclusion of urodynamic data performed regular postoperative periods would be more ideal but this is impractical and sometimes too invasive to most patients with normal spontaneous voiding.…”

Section: Introductionmentioning

confidence: 99%

Preoperative Videourodynamic Study Is Helpful in Predicting Long-term Postoperative Voiding Function in Asymptomatic Patients With Closed Spinal Dysraphism

Kim

Jung

et al. 2022

Int Neurourol J

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Purpose: Controversy exists regarding the role preoperative urodynamic study for asymptomatic closed spinal dysaraphism as it has failed to reveal the benefit in surgical decision and expectation of urological outcomes.We explore the relationship between preoperative videourodynamic study and postoperative urological outcomes after toilet training completed, focusing on their capability of spontaneous voiding. Methods:We retrospectively reviewed the data of 181 patients who underwent preventive spinal cord untethering and followed at least till the completion of toilet training. Before untethering, patients underwent preoperative videourodynamic study. Postoperative voiding function was evaluated in three phases 1) till postoperative 6 months 2) till the completion of toilet training 3) two years after toilet training. Changing distribution of emptying pattern at each period was described. Also, relevance to preoperative urodynamic parameters on spontaneous voiding and urinary continence after toilet training was assessed. Results: Spinal lipoma and low-lying conus were found in 145 (80%) and 128 (70.7%) patients, respectively. Spontaneous voiding was found in 125 (69.1%), 164 (90.6%) and 162 (89.5%) patients at postoperative 6 months, till the toilet training and two years after toilet training, respectively. Videourodynamics helped to clarify the presence of vesicourethral synergy. This was correlated with spontaneous voiding at postoperative 6 months and better urinary continence after 2 years of toilet training. Conclusions: Eventual spontaneous voiding was achieved till toilet training in 90% patients following preventive untethering. Those showing preoperative vesicourethral synergy was associated with faster achievement of spontaneous voiding and better urinary continence when they enter elementary school.

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