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Titolo:
One thousand video-urodynamic studies in children with non-neurogenic bladder sphincter dysfunction
Autore:
Hoebeke, P; Van Laecke, E; Van Camp, C; Raes, A; Van de Walle, J;
Indirizzi:
State Univ Ghent Hosp, Paediat Uronephrol Ctr, Dept Urol, B-9000 Ghent, Belgium State Univ Ghent Hosp Ghent Belgium B-9000 t Urol, B-9000 Ghent, Belgium State Univ Ghent Hosp, Paediat Uronephrol Ctr, Dept Paediat, B-9000 Ghent,Belgium State Univ Ghent Hosp Ghent Belgium B-9000 Paediat, B-9000 Ghent,Belgium
Titolo Testata:
BJU INTERNATIONAL
fascicolo: 6, volume: 87, anno: 2001,
pagine: 575 - 580
SICI:
1464-4096(200104)87:6<575:OTVSIC>2.0.ZU;2-V
Fonte:
ISI
Lingua:
ENG
Soggetto:
URINARY-TRACT INFECTION; NEUROLOGICALLY NORMAL-CHILDREN; VESICOURETERAL REFLUX; VOIDING DYSFUNCTION; CONSTIPATION; WET;
Keywords:
urge syndrome; dysfunctional voiding; lazy bladder; urodynamics;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
29
Recensione:
Indirizzi per estratti:
Indirizzo: Hoebeke, P State Univ Ghent Hosp, Dept Paediat Urol & Urogenital Reconstruct, De Pintelaan 185, B-9000 Ghent, Belgium State Univ Ghent Hosp De Pintelaan 185 Ghent Belgium B-9000 um
Citazione:
P. Hoebeke et al., "One thousand video-urodynamic studies in children with non-neurogenic bladder sphincter dysfunction", BJU INT, 87(6), 2001, pp. 575-580

Abstract

Objective To ascertain the aetiology and epidemiology of non-neurogenic bladder sphincter dysfunction (NNBSD) by assessing the results of prospectivevideo-urodynamic studies (VUD) in 1000 children. Patients and methods During a 4-year study period (January 1995 to December 1998) 1000 children prospectively underwent VUD to further define their NNBSD. After a noninvasive screening assessment consisting of a history, voiding diary. clinical examination, urine analysis, ultrasonography and uroflowmetry, those children who would benefit from further VUD were selected. The selection criteria included a history of urinary tract infection (UTI), a small bladder capacity not responding to training, dysfunctional uroflow,ultrasonographic abnormalities and resistance to therapy. During the studyperiod 3500 children were screened for incontinence problems. including monosymptomatic nocturnal enuresis; 1000 of these were selected for VUD (524 boys and 476 girls). Results The urodynamic diagnosis was of normal bladder-sphincter function in 62 (6.2%, male:female 44:56), urge syndrome in 582 (58%, 58:42). dysfunctional voiding in 316 (32%,, 49:51) and 'lazy bladder' in 40 (4%, 20:80). Boys diagnosed with a 'lazy bladder' were younger than those with urge syndrome and dysfunctional voiding, Girls with dysfunctional voiding were younger than those with urge syndrome, The incidence of UTI was significantly higher in girls than in boys: boys with NNBSD had no greater risk for UTI and in girls the general risk was 34%. Only in girls with a lazy bladder was there a significantly higher incidence of UTI (53%). Reflux occurred equally in all groups, with an overall incidence of 15%. The incidence of obstipation was significantly higher in girls with a lazy bladder. and overall was 17%. Conclusion These results from a large series provide a new insight into the epidemiology and pathophysiology of NNBSD. The age distribution provides evidence against a dysfunctional voiding sequence. The risk of developing UTI in NNBSD is greater only in girls. In children with a lazy bladder the risk is also significantly higher, indicating that residual urine is a greater risk factor than detrusor instability. Urge syndrome and dysfunctional voiding in girls carry the same risk for developing UTI, indicating that bladder instability is a higher risk factor for UTI than detrusor sphincter discoordination. All dysfunctions carry an equal risk for developing secondary reflux. Children with NNBSD have different primary diseases but all have a common risk of incontinence. UTIs, reflux and obstipation.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 06/07/20 alle ore 05:48:01