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Urodynamic patterns in children with dysfunctional voiding problems.

T D Allen, T C Bright

    Transactions of the American Association of Genito-Urinary Surgeons
    |January 1, 1977
    PubMed
    Summary
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    Children with dysfunctional voiding exhibit unique patterns of failed detrusor and sphincter coordination. This suggests a persistent developmental phase hindering mature bladder control and continence.

    Area of Science:

    • Pediatric Urology
    • Neuro-urology
    • Developmental Pediatrics

    Background:

    • Dysfunctional voiding (DV) in children is characterized by abnormal coordination during micturition.
    • Understanding the underlying mechanisms of DV is crucial for effective treatment.

    Purpose of the Study:

    • To investigate the specific patterns of intravesical pressure, anal sphincter electromyography, and urinary flow rate in children with DV.
    • To elucidate the coordination failures between the detrusor muscle and the urethral sphincter in this population.

    Main Methods:

    • Simultaneous urodynamic measurements were performed in 17 children diagnosed with dysfunctional voiding.
    • Parameters recorded included intravesical pressure, external anal sphincter electromyography, and urinary flow rate.

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    Main Results:

    • Distinct, individualized patterns of failed detrusor-sphincter coordination were observed in all participants.
    • A common finding was the inability to achieve coordinated relaxation of the sphincter during detrusor contraction.

    Conclusions:

    • The observed patterns in children with DV likely represent a persistent transitional phase in the development of micturitional control.
    • Forceful external urethral sphincter contraction, intended to prevent wetting, may hinder normal bladder emptying and contribute to DV.