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Related Experiment Videos

Lower urinary tract function after exstrophy closure.

J G Hollowell1, P D Hill, P G Duffy

  • 1Department of Urology, Hospital for Sick Children, London, UK.

Pediatric Nephrology (Berlin, Germany)
|September 1, 1992
PubMed
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Children with bladder exstrophy have key urinary tract function parameters that predict upper tract damage and limited bladder capacity. Higher leak pressure (LP) and fewer involuntary contractions correlate with better bladder capacity and reduced risk.

Area of Science:

  • Pediatric Urology
  • Urology
  • Nephrology

Background:

  • Bladder exstrophy presents significant challenges for lower urinary tract function.
  • Identifying risk factors for upper tract damage and impaired bladder capacity is crucial for surgical planning.

Purpose of the Study:

  • To define lower urinary tract functional parameters that pose a risk for upper tract damage in children with bladder exstrophy.
  • To identify factors that impair the development of bladder capacity prior to surgical continence procedures.

Main Methods:

  • Urodynamic evaluation, cystogram, ultrasound, and dimercaptosuccinic acid scan were performed on 28 children.
  • Analysis focused on leak pressure (LP), involuntary contractions, and end-fill pressure.

Main Results:

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  • Seven of 28 bladders showed no storage function (LP=0).
  • Higher LP and absence of involuntary contractions were associated with better bladder capacity.
  • A leak pressure (LP) > 30 cm H2O was linked to upper tract damage (hydronephrosis, scarring).
  • Elevated end-fill pressure (>10 cm H2O) was also associated with upper tract damage.

Conclusions:

  • Involuntary bladder contractions may hinder bladder capacity development.
  • Leak pressure (LP) > 30 cm H2O is a significant risk factor for upper tract damage.
  • End-fill pressure > 10 cm H2O may also indicate risk for upper tract damage in bladder exstrophy patients.