High yield of urodynamics performed for refractory nonneurogenic dysfunctional voiding in the pediatric population

In the pediatric population urodynamic evaluation for nonneurological causes has been previously reported as a low yield endeavor when considering patients with a primary diagnosis of dysfunctional voiding. We evaluated the rate of clinically significant urodynamic findings that would drive therapeutic intervention for a spectrum of urological disorders in pediatric patients without neurological deficit in whom initial conventional management had failed.

We retrospectively reviewed the charts of patients who had undergone urodynamics in the last 7 years. Patients with known neurological deficits were excluded.

A total of 805 pediatric urodynamic evaluations were performed from December 1997 to July 2004 at our institution, including 89 in patients with no known neurological diagnosis and charts available for review. Of the urodynamic studies 33 (37.1%) were reported as normal and 56 patients (62.9%) had clinically significant discoveries. Storage phase abnormalities were the predominant finding in 37 patients (66.1%), including uninhibited detrusor contractions in 31 (55.4%). Emptying phase abnormalities were less common (19 patients or 33.9%). There was no difference in the percent of patients with positive urodynamics findings depending on sex.

In our analysis evaluation of all recent urodynamics performed at a single institution revealed a high rate of pathological findings in patients with various nonneurological diagnoses.