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Voiding Pressures in Boys: Pdetmax versus PdetQmax - Does it Make a Difference?
Poonam Guha Vaze1, Subhasis Saha1, Rajiv Sinha2
1Department of Pediatric Surgery, AMRI Hospitals, Kolkata, West Bengal, India.
Journal of Indian Association of Pediatric Surgeons
|August 28, 2023
Summary
Voiding pressure measurements in boys using urodynamics (UDS) are more reliable with PdetQmax, an age-independent parameter, compared to Pdetmax. This finding could improve the diagnosis of pediatric voiding dysfunctions.
Area of Science:
- Pediatric Urology
- Urodynamics
- Lower Urinary Tract Symptoms
Background:
- Invasive urodynamics (UDS) is standard for pediatric voiding investigations.
- Current pediatric voiding pressure studies lack standardized nomenclature and yield heterogeneous results, limiting reliability.
- Adult urodynamics has established nomograms, unlike pediatric studies.
Purpose of the Study:
- To investigate voiding parameters during UDS in boys.
- To compare Pdetmax and PdetQmax values in pediatric patients.
Main Methods:
- Retrospective review of invasive UDS data from 106 neurologically normal boys (6 months-16 years).
- Analysis of detrusor pressure at maximum flow (PdetQmax) and maximum detrusor pressure (Pdetmax).
- Comparison of observed values with existing pediatric urodynamics literature.
Main Results:
- Pdetmax decreased with age, while PdetQmax remained age-independent.
- The difference between Pdetmax and PdetQmax was greater in younger children.
- Observed Pdetmax values aligned with heterogeneous literature, but PdetQmax values were significantly lower.
Conclusions:
- Pediatric voiding pressure studies are often unreliable due to heterogeneous Pdetmax values.
- PdetQmax is age-independent and significantly lower than Pdetmax.
- Utilizing PdetQmax may enhance the reproducibility and diagnostic value of pediatric urodynamics.
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