Urodynamic Changes with Age in Boys with Posterior Urethral Valves

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.