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One thousand video-urodynamic studies in children with non-neurogenic bladder sphincter dysfunction
P Hoebeke1, E Van Laecke, C Van Camp
1Department of Urology, Paediatric Uro-Nephrologic Centre, Ghent University Hospital, Ghent, Belgium. piet.hoebeke@rug.ac.be
BJU International
|April 12, 2001
Summary
Non-neurogenic bladder sphincter dysfunction (NNBSD) in children is most commonly urge syndrome or dysfunctional voiding. Urinary tract infections (UTIs) are a higher risk in girls, especially with a "lazy bladder" diagnosis.
Area of Science:
- Pediatric Urology
- Urodynamics
- Bladder Dysfunction
Background:
- Non-neurogenic bladder sphincter dysfunction (NNBSD) affects children, necessitating accurate diagnosis and understanding of its causes and prevalence.
- Video-urodynamic studies (VUD) are crucial for defining bladder-sphincter function in pediatric patients.
Purpose of the Study:
- To determine the etiology and epidemiology of NNBSD in children.
- To analyze the results of prospective video-urodynamic studies (VUD) in a large cohort of 1000 children.
Main Methods:
- Prospective VUD performed on 1000 children selected from 3500 screened for incontinence.
- Selection criteria included history of UTI, small bladder capacity, dysfunctional uroflow, or ultrasonographic abnormalities.
- Data collected included voiding diaries, clinical examinations, and uroflowmetry.
Main Results:
- Urge syndrome (58%) and dysfunctional voiding (32%) were the most common diagnoses in children with NNBSD.
- The incidence of urinary tract infections (UTI) was significantly higher in girls (34% overall) compared to boys.
- Girls with a 'lazy bladder' showed a significantly higher incidence of UTI (53%), and obstipation was also more common in this group.
Conclusions:
- NNBSD in children encompasses various conditions, with urge syndrome and dysfunctional voiding being most prevalent.
- Girls with NNBSD are at a greater risk for UTIs, particularly those with a 'lazy bladder' diagnosis, suggesting residual urine is a key risk factor.
- All forms of NNBSD carry an equal risk for secondary reflux, and children with NNBSD share common risks of incontinence, UTIs, reflux, and obstipation.