Children with unstable bladder: clinical and urodynamic observation

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.