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Related Experiment Videos

Neurogenic bladder: urodynamic and surgical aspects.

R Kataria1, M Bajpai, A Lall

  • 1Department of Paediatric Surgery, All India Institute of Medical Sciences, New Delhi.

Indian Journal of Pediatrics
|December 29, 2000
PubMed
Summary

Children with spina bifida experience vesico-urethral dysfunction. Urodynamic studies help classify bladder function and guide treatment for incontinence and upper urinary tract issues.

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Area of Science:

  • Pediatric Urology
  • Neurogenic Bladder
  • Spinal Dysraphism

Background:

  • Children with spina bifida frequently develop vesico-urethral dysfunction.
  • This dysfunction can lead to upper urinary tract deterioration or incontinence.
  • Factors like spinal surgery, hydrocephalus, and secondary cord tethering can worsen neuro-urologic conditions.

Purpose of the Study:

  • To classify patients with spinal dysraphism based on bladder and sphincter activity.
  • To evaluate the utility of urodynamic assessment in diagnosing and managing vesico-urethral dysfunction.
  • To identify risk factors for upper tract deterioration and predict incontinence management success.

Main Methods:

  • Analysis of urodynamic data from 31 children with spinal dysraphism and urologic symptoms.

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  • Utilized uroflowmetry, external sphincter electromyography (EMG), residual urine volume, and cystometry.
  • Correlated urodynamic findings with upper tract dilatation and leak point volume.

    • Main Results:

    • Twenty-three children had hyper-reflexic bladders; 8 had areflexic bladders.
    • Thirteen children presented with upper tract dilatation.
    • A significantly lower leak point volume was observed in patients with upper tract dilatation.

    Conclusions:

    • Urodynamic assessment is crucial for classifying detrusor and sphincter activity in children with spinal dysraphism.
    • These studies aid in guiding therapy, follow-up, and predicting outcomes for incontinence and upper tract deterioration.
    • Findings highlight the association between lower leak point volume and upper tract dilatation in this population.