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Video-urodynamic studies of minor voiding dysfunctions in children: an overview of 13 years' experience
G Passerini-Glazel1, A Cisternino, M C Camuffo
1Institute of Urology, University of Padova Medical School, Italy.
Insights
Video-urodynamic evaluation in children with minor voiding dysfunctions is often unnecessary. Many cases of frequency, urgency, and wetting in children may not require this advanced diagnostic tool.
Area of Science:
- Pediatric Urology
- Pediatric Nephrology
Background:
- Minor voiding dysfunctions in children include frequency, urgency, daytime wetting, squatting, and infrequent voiding.
- Urinary tract infections (UTIs) may coexist, but symptoms should persist even when infection-free.
- Exclusion criteria include infravesical obstruction, neurogenic bladder, and emotional disturbances.
Purpose of the Study:
- To report 13 years of experience with video-urodynamic evaluation in children diagnosed with minor voiding dysfunctions.
- To analyze clinical information, morphofunctional correlations, and the relationship with recurrent UTIs, vesico-ureteric reflux, and upper urinary tract dilatation.
Main Methods:
- Retrospective review of 13 years of video-urodynamic evaluations in children with minor voiding dysfunctions.
- Correlation of clinical data with urodynamic findings and upper urinary tract status.
Main Results:
- Video-urodynamic evaluation was performed in children presenting with symptoms of minor voiding dysfunctions.
- Analysis focused on clinical presentation, urodynamic findings, and associated urinary tract abnormalities.
Conclusions:
- Approximately 60% of the evaluated patients in this cohort may not have required video-urodynamic evaluation based on current clinical judgment.
- This suggests a potential overutilization of video-urodynamics for diagnosing minor voiding dysfunctions in children.
Abstract:
By the definition 'minor voiding dysfunctions' is understood children with a history of frequency, urgency, daytime wetting, squatting, and infrequent voiding, singly or in combination. Urinary tract infections (UTI) are often present but symptoms must also be present when the children are free of infection. The upper urinary tract is generally normal or has minor anomalies. Any evidence of infravesical obstruction, frank or occult neurogenic bladder, or emotional disturbances must be excluded. In this study we report 13 years' experience of video-urodynamic evaluation in children with minor voiding dysfunctions, with special reference to clinical information, morphofunctional correlations, relationship with recurrent UTI, vesico-ureteric reflux and dilatation of the upper urinary tract. According to our experience we estimate that about 60% of the patients evaluated in this study would not require a video-urodynamic evaluation today.