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Relationship between dysfunctional voiding and reflux.

S A Koff1

  • 1Department of Surgery, Ohio State University College of Medicine, Columbus.

The Journal of Urology
|November 1, 1992
PubMed
Summary

Dysfunctional voiding, including bladder instability and nonneurogenic neurogenic bladder, causes urinary obstruction. This obstruction can lead to vesicoureteral reflux by altering bladder and ureterovesical junction function.

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Area of Science:

  • Urology
  • Pediatric Urology
  • Nephrology

Background:

  • Bladder instability and nonneurogenic neurogenic bladder are distinct voiding dysfunctions.
  • Both conditions can lead to functional urinary obstruction.

Purpose of the Study:

  • To analyze the urodynamic mechanisms linking dysfunctional voiding to vesicoureteral reflux.
  • To elucidate the role of bladder pressures in the development of reflux.

Main Methods:

  • Urodynamic studies were reviewed.
  • Literature review on bladder function, obstruction, and vesicoureteral reflux was conducted.

Main Results:

  • Both bladder instability and nonneurogenic neurogenic bladder cause functional urinary obstruction.
  • High end-filling bladder pressures, not high voiding pressures, are implicated in reflux.
  • This mechanism explains why reflux is less common at high bladder pressures.

Conclusions:

  • Functional urinary tract obstruction from dysfunctional voiding initiates and perpetuates vesicoureteral reflux.
  • Understanding these urodynamic mechanisms is crucial for managing reflux.

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