Otávio Augusto Fonseca Reis, Hilton Naoto Ito, Juliana de Oliveira Otávio, Diniz José de Oliveira Filho, Eleonora Moreira Lima, José de Bessa, Paula Larissa Lebron da Silva, Mônica Maria de Almeida Vasconcelos, Flávia Cristina de Carvalho Mrad
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We assessed clinical and urodynamic parameters before and after surgery, focusing on improvements in urinary incontinence, vesicoureteral reflux (VUR), bladder capacity, compliance, and end filling detrusor pressure (EFP).</p><p><strong>Results: </strong>A total of 212 NB patients underwent AC and were evaluated for urinary incontinence before and after surgery. Two studies showed a 76.5% to 78.9% improvement in incontinence without bladder outlet procedures (BOP). Another study found no significant difference in incontinence improvement rates between AC with and without BOP. The VUR resolution rate assessed in three studies ranged from 12.5 to 64%. Three studies showed a variation in bladder capacity from 52.8 to 70% of the expected bladder capacity pre-AC to 95.9 to 119%, post-AC. A fourth study showed a variation in bladder capacity from 87 ml pre-AC to 370 ml post-AC. Two studies showed a variation from 3.2 to 4.6 ml/cm H<sub>2</sub>O pre-AC to 13.7 to 41.3 ml/cm H<sub>2</sub>O post-AC in bladder compliance. The EFP in three studies varied from 37.2 to 47.6 cm H<sub>2</sub>O pre-AC to 11 to 17.4 cm H<sub>2</sub>O post-AC.</p><p><strong>Conclusion: </strong>After AC, urinary incontinence, bladder capacity, EFP, and bladder compliance improved in children and adolescents with NB.</p>","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":"355-365"},"PeriodicalIF":2.6000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Clinical and urodynamic findings in children and adolescents with neurogenic bladder undergoing augmentation cystoplasty: a systematic review.\",\"authors\":\"Otávio Augusto Fonseca Reis, Hilton Naoto Ito, Juliana de Oliveira Otávio, Diniz José de Oliveira Filho, Eleonora Moreira Lima, José de Bessa, Paula Larissa Lebron da Silva, Mônica Maria de Almeida Vasconcelos, Flávia Cristina de Carvalho Mrad\",\"doi\":\"10.1007/s00467-024-06499-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Augmentation cystoplasty (AC) is a procedure to improve the clinical and urodynamic parameters of neurogenic bladder (NB) in children and adolescents refractory to other treatments. 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引用次数: 0
摘要
背景：增强膀胱成形术（AC）是一种改善其他治疗方法难治的儿童和青少年神经源性膀胱（NB）的临床和尿动力学参数的手术。我们进行了一项系统性综述，以研究接受 AC 的 NB 儿童和青少年的这些参数：我们遵循 PRISMA 指南，在 2024 年 3 月之前检索了电子数据库中涉及接受 AC 治疗的 3 至 19 岁 NB 患者的研究。我们评估了手术前后的临床和尿动力学参数，重点关注尿失禁、膀胱输尿管反流（VUR）、膀胱容量、顺应性和末端充盈逼尿肌压力（EFP）的改善情况：共有 212 名 NB 患者接受了 AC 术，并在术前和术后接受了尿失禁评估。两项研究显示，在未进行膀胱出口手术（BOP）的情况下，尿失禁的改善率为 76.5% 至 78.9%。另一项研究发现，有膀胱出口手术和无膀胱出口手术的尿失禁改善率没有明显差异。三项研究评估的 VUR 缓解率从 12.5% 到 64% 不等。三项研究显示，膀胱容量的变化范围从 AC 前预期膀胱容量的 52.8% 到 70%，到 AC 后的 95.9% 到 119%。第四项研究显示，膀胱容量的变化范围从急性肾功能衰竭前的 87 毫升到急性肾功能衰竭后的 370 毫升。两项研究显示，膀胱顺应性的变化范围从膀胱活动前的 3.2 至 4.6 毫升/厘米 H2O 到膀胱活动后的 13.7 至 41.3 毫升/厘米 H2O。三项研究中的 EFP 从 AC 前的 37.2 至 47.6 厘米 H2O 到 AC 后的 11 至 17.4 厘米 H2O 不等：结论：AC 后，NB 儿童和青少年的尿失禁、膀胱容量、EFP 和膀胱顺应性均有所改善。
Clinical and urodynamic findings in children and adolescents with neurogenic bladder undergoing augmentation cystoplasty: a systematic review.
Background: Augmentation cystoplasty (AC) is a procedure to improve the clinical and urodynamic parameters of neurogenic bladder (NB) in children and adolescents refractory to other treatments. We performed a systematic review to investigate these parameters in children and adolescents with NB undergoing AC.
Methods: We followed PRISMA guidelines and searched electronic databases until March 2024 for studies involving patients aged three to 19 years diagnosed with NB undergoing AC. We assessed clinical and urodynamic parameters before and after surgery, focusing on improvements in urinary incontinence, vesicoureteral reflux (VUR), bladder capacity, compliance, and end filling detrusor pressure (EFP).
Results: A total of 212 NB patients underwent AC and were evaluated for urinary incontinence before and after surgery. Two studies showed a 76.5% to 78.9% improvement in incontinence without bladder outlet procedures (BOP). Another study found no significant difference in incontinence improvement rates between AC with and without BOP. The VUR resolution rate assessed in three studies ranged from 12.5 to 64%. Three studies showed a variation in bladder capacity from 52.8 to 70% of the expected bladder capacity pre-AC to 95.9 to 119%, post-AC. A fourth study showed a variation in bladder capacity from 87 ml pre-AC to 370 ml post-AC. Two studies showed a variation from 3.2 to 4.6 ml/cm H2O pre-AC to 13.7 to 41.3 ml/cm H2O post-AC in bladder compliance. The EFP in three studies varied from 37.2 to 47.6 cm H2O pre-AC to 11 to 17.4 cm H2O post-AC.
Conclusion: After AC, urinary incontinence, bladder capacity, EFP, and bladder compliance improved in children and adolescents with NB.
期刊介绍：
International Pediatric Nephrology Association
Pediatric Nephrology publishes original clinical research related to acute and chronic diseases that affect renal function, blood pressure, and fluid and electrolyte disorders in children. Studies may involve medical, surgical, nutritional, physiologic, biochemical, genetic, pathologic or immunologic aspects of disease, imaging techniques or consequences of acute or chronic kidney disease. There are 12 issues per year that contain Editorial Commentaries, Reviews, Educational Reviews, Original Articles, Brief Reports, Rapid Communications, Clinical Quizzes, and Letters to the Editors.
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