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Urodynamic investigation of valve bladder syndrome in children

Jian Guo Wen1, Yuan Li, Qing Wei Wang

  • 1The Pediatric Urodynamic Center, Department of Paediatric Surgery, First Teaching Hospital of Zhengzhou University, Institute of Clinical Medical Research Universities, No.1, Jianshe East Road, Henan Province, Zhengzhou City 450052, China. jgwen@zzu.edu.cn

Journal of Pediatric Urology
|October 25, 2008
PubMed

Insights

Urodynamic studies reveal that children with valve bladder syndrome (VBS) experience worsening bladder dysfunction over time, even after treatment. Post-voiding residual volume increases, while bladder compliance decreases with age.

Area of Science:

  • Pediatric Urology
  • Urodynamics
  • Pediatric Nephrology

Background:

  • Valve bladder syndrome (VBS) is a congenital condition affecting the lower urinary tract in children.
  • Urodynamic evaluation is crucial for assessing bladder function in VBS patients.
  • Understanding the long-term urodynamic changes post-treatment is essential for patient management.

Purpose of the Study:

  • To investigate the urodynamic manifestations in children with VBS.
  • To determine the relationship between urodynamic findings and the postoperative experience in VBS patients.
  • To assess the impact of time after urethral valve fulguration on bladder function.

Main Methods:

  • A cohort of 16 children diagnosed with VBS was studied.
  • Patients were divided into two groups based on the timing of urodynamic assessment post-urethral valve fulguration (less than 1 year vs. more than 1 year).
  • Urodynamic parameters including maximum detrusor voiding pressure, bladder compliance, post-voiding residual, and maximum bladder capacity were analyzed according to International Children's Continence Society standards.

Main Results:

  • Children assessed more than 1 year after fulguration (group 2) showed significantly decreased maximum detrusor voiding pressure and bladder compliance compared to those assessed less than 1 year post-surgery (group 1).
  • Group 2 also exhibited significantly increased post-voiding residual volume and maximum bladder capacity.
  • While not statistically significant, group 2 demonstrated a trend towards more intermittent detrusor contractions during voiding.

Conclusions:

  • Children with VBS often present with complex bladder dysfunctions identifiable through urodynamics.
  • Despite successful urethral valve fulguration, progressive changes in bladder function, including decreased detrusor voiding pressure and compliance, and increased post-voiding residual and bladder capacity, are observed as children grow.
  • Urodynamic monitoring is vital for managing VBS patients and understanding long-term functional outcomes.
Abstract

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