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Detrusor Pressures Change with Repeat Filling Cystometry in Myelodysplastic Children with Neurogenic Lower Urinary Tract Dysfunction

2020; Lippincott Williams & Wilkins; Volume: 205; Issue: 2 Linguagem: Inglês

10.1097/ju.0000000000001335

1527-3792

Raziye Ergün, Çağrı Akın Şekerci, Yılören Tanıdır, Bahriye Atmış, Atilla Gemici, Selçuk Yücel,

Urological Disorders and Treatments

No AccessJournal of UrologyPediatric Urology1 Feb 2021Detrusor Pressures Change with Repeat Filling Cystometry in Myelodysplastic Children with Neurogenic Lower Urinary Tract DysfunctionThis article is commented on by the following:Editorial CommentEditorial Comment Raziye Ergun, Cagri Akin Sekerci, Yiloren Tanidir, Bahriye Atmis, Atilla Gemici, and Selcuk Yucel Raziye ErgunRaziye Ergun Pediatric Urology, Erzurum Training and Research Hospital, Erzurum, Turkey More articles by this author , Cagri Akin SekerciCagri Akin Sekerci Department of Urology, Division of Pediatric Urology, School of Medicine, Marmara University, Istanbul, Turkey More articles by this author , Yiloren TanidirYiloren Tanidir Department of Urology, School of Medicine, Marmara University, Istanbul, Turkey More articles by this author , Bahriye AtmisBahriye Atmis Pediatric Nephrology, Erzurum Training and Research Hospital, Erzurum, Turkey More articles by this author , Atilla GemiciAtilla Gemici Pediatric Nephrology, Erzurum Training and Research Hospital, Erzurum, Turkey More articles by this author , and Selcuk YucelSelcuk Yucel *Correspondence: Department of Urology, Division of Pediatric Urology, School of Medicine, Marmara University, Fevzi Çakmak Mah., Muhsin Yazicioglu Cad. No. 10, Ust Kaynarca, Pendik, Istanbul, Turkey telephone: 90-216-657-0606; FAX: 90-216-657-0699; E-mail Address: [email protected] Department of Urology, Division of Pediatric Urology, School of Medicine, Marmara University, Istanbul, Turkey More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001335AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The International Children’s Continence Society recommends urodynamics repeated at least twice for the optimal result. We aimed to search if 3 times repeat filling urodynamics in the same session would change the urodynamics parameters in children with neurogenic lower urinary tract dysfunction due to myelodysplasia. Materials and Methods: We investigated urodynamic reports and charts of 80 consecutive children with neurogenic lower urinary tract dysfunction due to myelodysplasia who underwent 3 repeat, same session filling cystometry studies between June 2017 and December 2018. Maximum detrusor pressure, maximum cystometric capacity, detrusor leak point pressure, compliance, residual urine volume and maximum cystometric capacity/estimated bladder capacity for age ratio were compared among all 3 filling cystometries. Results: The median age was 4.3 years (IQR 5.8). Of the patients 39 (48.75%) were girls and 41 (51.25%) were boys. Primary pathological finding was myelomeningocele in 69 patients (86.3%). Maximum cystometric capacity, compliance, residual urine and maximum cystometric capacity/estimated bladder capacity for age were found comparable in 3 repeat cystometries. However, maximum detrusor pressure at first filling was higher compared to others (second, p=0.015, and third, p=0.002). Detrusor leak point pressure at the first filling was also higher compared to the third (p <0.001). Detrusor overactivity was persistent in all 3 fillings in 85% of patients (68 of 80). Of the patients 68 (85%) remained in the same risk group according to detrusor leak point pressure (cutoff 40 cmH2O). Conclusions: Maximum cystometric capacity and detrusor overactivity are comparable in 3 repeat cystometries but detrusor pressures significantly decrease in the repeat fillings. In our practice we plan our management according to the most worrisome urodynamics parameters for a safer proactive approach. References 1. : Kidney function surveillance in the National Spina Bifida Patient Registry: a retrospective cohort study. J Urol 2020; 204: 578. Link, Google Scholar 2. : International Children's Continence Society standardization report on urodynamic studies of the lower urinary tract in children. Neurourol Urodyn 2015; 34: 640. 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Google Scholar See Editorial on page 333. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byMetcalfe P (2020) Nuances and Pitfalls in Pediatric Urodynamics: Perfecting ImperfectionJournal of Urology, VOL. 205, NO. 2, (333-334), Online publication date: 1-Feb-2021.Tanaka S (2020) This Month in Pediatric UrologyJournal of Urology, VOL. 205, NO. 2, (323-323), Online publication date: 1-Feb-2021.Related articlesJournal of Urology9 Nov 2020Editorial CommentJournal of Urology9 Nov 2020Editorial Comment Volume 205Issue 2February 2021Page: 577-585Supplementary Materials Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.Keywordsneural tube defectsurodynamicsurinary bladderurinary bladderoveractiveneurogenicMetricsAuthor Information Raziye Ergun Pediatric Urology, Erzurum Training and Research Hospital, Erzurum, Turkey More articles by this author Cagri Akin Sekerci Department of Urology, Division of Pediatric Urology, School of Medicine, Marmara University, Istanbul, Turkey More articles by this author Yiloren Tanidir Department of Urology, School of Medicine, Marmara University, Istanbul, Turkey More articles by this author Bahriye Atmis Pediatric Nephrology, Erzurum Training and Research Hospital, Erzurum, Turkey More articles by this author Atilla Gemici Pediatric Nephrology, Erzurum Training and Research Hospital, Erzurum, Turkey More articles by this author Selcuk Yucel Department of Urology, Division of Pediatric Urology, School of Medicine, Marmara University, Istanbul, Turkey *Correspondence: Department of Urology, Division of Pediatric Urology, School of Medicine, Marmara University, Fevzi Çakmak Mah., Muhsin Yazicioglu Cad. No. 10, Ust Kaynarca, Pendik, Istanbul, Turkey telephone: 90-216-657-0606; FAX: 90-216-657-0699; E-mail Address: [email protected] More articles by this author Expand All See Editorial on page 333. Advertisement PDF downloadLoading ...