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Related Experiment Videos

Urethral instability as an important element of dysfunctional voiding.

R L Vereecken1, W Proesmans

  • 1Department of Urology and Pediatric Nephrology, University Hospital Gasthuisberg, Leuwen, Belgium.

The Journal of Urology
|January 27, 2000
PubMed
Summary

Dysfunctional voiding in girls often involves detrusor and urethral instability during bladder filling, not just during voiding. This instability may cause urge sensations and staccato voiding patterns.

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Area of Science:

  • Pediatric Urology
  • Urodynamics
  • Pelvic Floor Dysfunction

Background:

  • Dysfunctional voiding (DV) is characterized by incomplete perineal relaxation during micturition.
  • The underlying causes of DV, particularly during bladder filling, remain incompletely understood.

Purpose of the Study:

  • To investigate detrusor and urethral behavior during bladder filling in girls with dysfunctional voiding.
  • To elucidate the pathological mechanisms contributing to this condition.

Main Methods:

  • Urodynamic assessment including bladder and urethral pressure monitoring.
  • Anal sphincter electromyography (EMG) during slow bladder filling in 15 girls with refractory symptoms.
  • Exclusion of neurological conditions.

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Main Results:

  • Urethral instability observed in 8 girls (urethral pressure decreases with EMG silence or intermittent spasms).
  • Detrusor instability noted in 12 girls; bladder pressure was normal in 1 and hypoactive in 2.
  • Combined detrusor and urethral instability occurred in 6 cases.

Conclusions:

  • Dysfunctional voiding is a misnomer; pathology exists during bladder filling.
  • Detrusor and urethral instability frequently contribute to urge sensations and staccato voiding in affected girls.