Urodynamic Changes with Age in Boys with Posterior Urethral Valves

British journal of medical & surgical urology Pub Date : 2020-01-01 DOI:10.35248/2168-9857.20.9.236

S. Wani, Viney Jadhav, N. Munianjana

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Abstract

Introduction: Bladder dysfunction is a common cause of morbidity in posterior urethral valve (PUV) patients and urodynamic study provides a useful tool to identify the bladder dysfunction. The aim of this study was to evaluate the urodynamic patterns in different age groups in PUV patients. Material and Methods: Toilet trained patients more than 4 years of age were included in the study. Invasive urodynamic study was done in all patients. Patients were divided in to the three groups; Group-1 (4-8 years), group-2 (9-13 years) and group-3 (14-18 years). Various urodynamic parameters which were noted in each patient include compliance, bladder stability, bladder capacity, detrusor pressure during voiding, detrusor sphincter dysynergia and post void residue. Results: 47 patients were included in the study. Age of patients ranged from 4 years to 17.8 years with mean age of 6.4 years. Bladder hyperreflexia (14.3% in group-1, 14.3% in group-2 and 8.3% in group-3), poor compliance (9.5% in group-1, 28.6% in group-2 and 41.7% in group-3), bladder capacity (normal in 76.2% group-1, 50.0% in group-2 and 33.3% in group-3), (decreased in 14.3% group-1, 28.6% in group-2 and 16.7% in group-3) and (increased in 9.5% group-1, 21.4% in group-2 and 50.0% in group-3), detrusor pressure during voiding (sustained in 42.5% group-1, 42.8% in group-2 and 25.0% in group-3), (waxing and waning in 28.6% group-1, 28.6% in group-2 and 41.7% in group-3) and myogenic failure in 14.3% group-1, 21.4% in group-2 and 33.3% in group-3. Conclusion: Urodynamic pattern shows considerable overlap during childhood and through adolescence with hyper contractility generally seen in young children and hypo contractility and myogenic failure in older boys.

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男孩后尿道瓣膜的尿动力学随年龄变化

膀胱功能障碍是后尿道瓣膜(PUV)患者发病的常见原因，尿动力学研究为识别膀胱功能障碍提供了有用的工具。本研究的目的是评估不同年龄组PUV患者的尿动力学模式。材料与方法:研究对象为4岁以上患者。所有患者均行有创尿动力学研究。将患者分为三组;组1(4-8岁)、组2(9-13岁)、组3(14-18岁)。在每位患者中记录的各种尿动力学参数包括依从性、膀胱稳定性、膀胱容量、排尿时逼尿肌压力、逼尿肌括约肌协同障碍和排尿后残留。结果:47例患者纳入研究。患者年龄4 ~ 17.8岁，平均6.4岁。膀胱反射性增高(1组14.3%、2组14.3%、3组8.3%)、顺应性差(1组9.5%、2组28.6%、3组41.7%)、膀胱容量(1组76.2%、2组50.0%、3组33.3%)、(1组下降14.3%、2组下降28.6%、3组下降16.7%)、(1组增加9.5%、2组增加21.4%、3组增加50.0%)、排尿时逼尿肌压力(1组持续42.5%、2组持续42.8%、3组持续25.0%)、(1、2、3组分别为28.6%、28.6%、41.7%)，1、2、3组分别为14.3%、21.4%、33.3%。结论:尿动力学模式在儿童期和青春期表现出相当大的重叠，通常在幼儿中出现过度收缩，而在大男孩中出现收缩不足和肌源性衰竭。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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British journal of medical & surgical urology

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