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Role of urodynamics in male patients of high-anorectal malformations: a prospective study

Vineet Binu1, Vedarth Dash1, Monika Bawa2

  • 1Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.

Pediatric Surgery International
|January 23, 2021
PubMed

Insights

Urodynamic studies reveal that many boys with high-anorectal malformations (HARM) have unsafe bladders, indicating potential neurovesical dysfunction. Early detection through urodynamics aids in renal protective therapy for HARM patients.

Area of Science:

  • Pediatric Urology
  • Neuro-urology
  • Surgical Outcomes

Background:

  • Anorectal malformations (ARM) in boys can be associated with spinal anomalies, potentially leading to neurogenic bladder.
  • Limited urodynamic data exists specifically for male children with high-anorectal malformations (HARM).

Purpose of the Study:

  • To investigate the urodynamic profile in male patients who have undergone surgical correction for high-anorectal malformations.
  • To identify potential occult neurovesical dysfunction in this patient cohort.

Main Methods:

  • Prospective study of male HARM patients post-surgical repair.
  • Urodynamic studies (UDS) categorized bladders as safe or unsafe based on detrusor pressure, variability, and post-void residue.
  • MRI was utilized selectively for patients with abnormal UDS to investigate spinal causes.

Main Results:

  • 31.7% of patients showed bladder wall thickening on ultrasound.
  • Urodynamics revealed reduced bladder capacity (31.7%) and compliance (30%).
  • 10% had elevated detrusor pressures, 19.5% showed detrusor overactivity with elevated pressures, and 30% had unsafe bladders.

Conclusions:

  • Urodynamic studies are effective in detecting subclinical neurovesical dysfunction in HARM patients.
  • Early identification of unsafe bladders facilitates timely renal protective interventions.
  • This approach can prevent long-term complications associated with neurovesical dysfunction in HARM survivors.
Abstract

Keywords:
Detrusor overactivityHigh-anorectal malformationUrodynamics

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