Related Experiment Videos
Children with unstable bladder: clinical and urodynamic observation
Insights
This study analyzed 303 patients with unstable bladders, finding effective treatment with anticholinergics, especially in children. Most pediatric cases of bladder instability were successfully managed, highlighting the importance of timely intervention.
Area of Science:
- Urology
- Pediatric Urology
- Clinical Analysis
Background:
- Unstable bladder, characterized by detrusor overactivity without neurogenic lesions, affects diverse age groups.
- The study population included 303 patients diagnosed via urodynamic studies.
- Age distribution showed peaks in children under 10 and adults aged 60-80.
Purpose of the Study:
- To analyze clinical characteristics and treatment outcomes of unstable bladders.
- To investigate the prevalence and presentation of unstable bladders in pediatric patients.
- To discuss the etiology of bladder instability in different age demographics.
Main Methods:
- Clinical analysis of 303 patients diagnosed with unstable bladder using urodynamic studies.
- Age and sex distribution analysis.
- Evaluation of presenting symptoms, objective findings, and treatment regimens in pediatric patients.
Main Results:
- In children (<15 years), common complaints included enuresis (54%), urge incontinence (41%), and fever (25%).
- Objective findings in children included vesicoureteral reflux (29%), urinary tract infection (20%), and distal urethral stenosis (8%).
- Unstable bladder type I was diagnosed in 78% of pediatric patients; 93% achieved satisfactory bladder control with anticholinergics and/or antimicrobials.
Conclusions:
- Anticholinergic therapy, often combined with antimicrobials, is effective for managing pediatric unstable bladders.
- Surgical intervention followed by anticholinergic maintenance is crucial for cases with vesicoureteral reflux.
- Bladder instability presents differently across age groups, necessitating tailored etiological considerations and treatment approaches.
Abstract:
A clinical analysis was done on 303 patients diagnosed by urodynamic study as having an unstable bladder, which was characterized by uninhibited contraction of the detrusor without any overt neurogenic lesions. An age distribution histogram demonstrated 2 peaks: children less than 10 years old and patients between 60 and 80 years old. Sex was not significant in the children but men predominated in the adults. There were 68 children less than 15 years old with the chief complaints of enuresis (54 per cent), urge incontinence (41 per cent) and fever (25 per cent). The objective findings were vesicoureteral reflux in 29 children, urinary tract infection in 20 and distal urethral stenosis in 8. An unstable bladder type I, the occurrence of uninhibited contractions during the filling phase of cystometry, was found in 53 children (78 per cent). We noted several postures that the children characteristically used to resist unheralded urgency and to prevent urine from leaking. The main therapeutic regimen consisted of anticholinergics with or without antimicrobials. Several children underwent surgical intervention. Once the antireflux operation was performed followup with anticholinergics was of primary importance. The unstable bladders of 63 of the 68 children (93 per cent) have been controlled satisfactorily. The etiology of bladder instability is discussed for both groups of patients.