Natural history and etiology of high pressure voiding in male infants

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Ultrasonography of the Adult Male Urinary Tract for Urinary Functional Testing

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Midori Ichino1, Yasuhiko Igawa, Satoshi Seki

  • 1Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan.

The Journal of Urology
|October 20, 2007
PubMed

Insights

High voiding pressure in infants stems from detrusor-sphincter dyscoordination and hypercontractility. Maturation improves this condition primarily through reduced detrusor hypercontractility.

Area of Science:

  • Pediatric Urology
  • Urodynamics
  • Infant Lower Urinary Tract Function

Background:

  • High voiding pressure in male infants is a clinical concern.
  • Understanding its etiology and maturation patterns is crucial for diagnosis and management.

Purpose of the Study:

  • Determine the causes of high voiding pressure in male infants.
  • Clarify the mechanisms behind its improvement with age.

Main Methods:

  • Retrospective review of 106 videourodynamic studies from 78 male infants.
  • Analysis of age, bladder capacity, and maximum voiding detrusor pressure.
  • Continuous fluoroscopic recording of lower urinary tract during 64 voiding phases.

Main Results:

  • Maximum voiding detrusor pressure negatively correlated with age and bladder capacity.
  • Observed increased detrusor pressure, sphincter activity, and urethral abnormalities.
  • Urine stream interruption occurred in 92% of patients, independent of age.

Conclusions:

  • High voiding pressure results from detrusor-sphincter dyscoordination and hypercontractility.
  • Maturation improves this condition mainly via resolution of detrusor hypercontractility.
  • External sphincter relaxation was adequate in all cases.
Abstract

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