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Prevalence of hypercontractility in male and female infants with vesico-ureteral reflux

M L Capitanucci1, M Silveri, G Mosiello

  • 1Department of Pediatric Surgery, Ospedale Pediatrico Bambino Gesù di Palidoro, Rome, Italy.

European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [Et Al] = Zeitschrift Fur Kinderchirurgie
|September 12, 2000
PubMed

Insights

Infants with vesico-ureteral reflux (VUR) often have bladder dysfunction, especially males under one year old. Early identification of bladder issues in VUR patients is crucial for effective management.

Area of Science:

  • Pediatric Urology
  • Nephrology
  • Pediatric Surgery

Background:

  • Vesico-ureteral reflux (VUR) is a common condition in infants.
  • The presence and characteristics of bladder dysfunction in infants with VUR require further investigation.
  • Understanding gender, age, and severity differences in VUR-associated bladder dysfunction is important for clinical practice.

Purpose of the Study:

  • To determine the prevalence of bladder dysfunction in infants diagnosed with VUR.
  • To analyze how bladder dysfunction varies based on infant gender, age at presentation, and VUR severity.
  • To investigate the relationship between VUR and specific urodynamic parameters like hypercontractility and high voiding detrusor pressure.

Main Methods:

  • A cohort of 37 infants (24 male, 13 female) aged 2-24 months with VUR (grades II-V) underwent cystometry.
  • Urodynamic parameters, including instability and maximal voiding detrusor pressure (VDP), were assessed.
  • Hypercontractility was defined as high VDP (>90 cm H2O) and/or instability; 10 infants also had natural filling cystometry.

Main Results:

  • Hypercontractility was observed in 75% of males and 46% of females with VUR (p<0.004).
  • High VDP was significantly more prevalent in males (50%) compared to females (7%) (p < 0.001).
  • Mean VDP was higher in males, younger infants (<1 year), and those with severe VUR compared to their counterparts.

Conclusions:

  • Bladder dysfunction is a significant finding in infants with VUR, particularly in younger males.
  • Gender plays a role in the presentation and severity of bladder dysfunction associated with VUR.
  • Early identification and management of bladder dysfunction are essential for infants with VUR, as it may not solely stem from vesico-ureteral junction malformations.
Abstract

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