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Influence of high bladder pressure on vesicoureteral reflux and its resolution

Banu Acar1, F Inci Arikan, Cankon Germiyanoğlu

  • 1Department of Pediatrics, Ankara Research and Training Hospital, Ankara, Turkey. banuacar@gmail.com

Urologia Internationalis
|January 28, 2009
PubMed

Insights

Children with voiding dysfunction and vesicoureteral reflux (VUR) should have bladder function evaluated. High detrusor pressures in these patients may indicate VUR and renal damage, requiring careful assessment.

Area of Science:

  • Pediatric Urology
  • Pediatric Nephrology
  • Urodynamics

Background:

  • Voiding dysfunction in children can lead to lower urinary tract symptoms, urinary tract infections, renal damage, and vesicoureteral reflux (VUR).
  • Understanding the relationship between bladder pressure and VUR is crucial for managing pediatric voiding dysfunction.

Purpose of the Study:

  • To investigate the association between detrusor pressure, VUR grade, and renal scintigraphy findings in children with dysfunctional voiding.
  • To evaluate the impact of anticholinergic therapy on VUR and voiding patterns in this patient group.

Main Methods:

  • A cohort of 30 children (22 girls, 8 boys; median age 8.2 years) with VUR and voiding dysfunction were evaluated between 2004 and 2007.
  • Urodynamic studies, renal scans, and voiding cystourethrography were performed for all participants.
  • Patients received anticholinergic therapy, and outcomes regarding VUR and voiding patterns were assessed.

Main Results:

  • A significant correlation was found between renal scarring and detrusor pressures (p = 0.018).
  • The highest detrusor pressures were observed in children with urge syndrome.
  • VUR grade showed a significant correlation with detrusor pressures (p = 0.038). After therapy, VUR resolved in 37%, improved in 33%, and remained unchanged in 30% of patients.

Conclusions:

  • All children diagnosed with VUR require a thorough assessment of their bladder function.
  • Elevated detrusor pressures in children warrant careful evaluation for the presence of VUR and potential renal damage.
Abstract

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