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[Indications for urodynamic studies in childhood: our experience with 214 surgical patients]
R Martín-Crespo Izquierdo1, R Luque Mialdea, J Cerdá Berrocal
1Departamento de Pediatría y Cirugía Pediátrica, Hospital General Universitario Gregoŕio Marañón, Madrid.
Insights
Urodynamic evaluation in children reveals high rates of abnormalities in conditions like vesicoureteral reflux and urethral strictures. This assessment aids in guiding surgical decisions and optimizing treatment for pediatric urologic conditions.
Area of Science:
- Pediatric Urology
- Urodynamics
- Surgical Pathology
Background:
- Urodynamic evaluation is crucial for assessing pediatric patients with medical and surgical conditions.
- Previous studies highlight the importance of understanding bladder and urethral function.
Purpose of the Study:
- To present urodynamic findings in pediatric patients with specific surgical pathologies.
- To determine the incidence of urodynamic abnormalities in children with vesicoureteral reflux, urethral stricture, posterior urethral valves, and spina bifida.
Main Methods:
- Retrospective analysis of urodynamic evaluations performed between 1983 and 1994.
- Inclusion of 214 pediatric patients with surgical pathologies.
Main Results:
- High incidence of urodynamic abnormalities observed: 46.5% in vesicoureteral reflux, 88.4% in urethral strictures, 54.4% in posterior urethral valves, and 100% in spina bifida.
- Significant correlation between specific pathologies and urodynamic dysfunction.
Conclusions:
- Urodynamic assessment plays a vital role in surgical indication for pediatric urologic conditions.
- Understanding the vesicourethral complex state can guide individualized medical treatment, potentially delaying or avoiding surgery.
Abstract:
Between 1983 and 1994, 515 pediatric patients with medical and/or surgical problems underwent urodynamic evaluation. We present the urodynamic findings of 214 children with surgical pathology: 73 cases with vesicoureteral reflux, 26 with urethral stricture, 11 with posterior urethral valves and 104 cases with lipo- and myelomeningocele. We found a high incidence of urodynamic abnormalities associated to these pathologies: 46.5 in patients with vesicoureteral reflux, 88.4% in urethral strictures, 54.4% in posterior urethral valves and 100% in patients with spina bifida. In our opinion, the urodynamic assessment has a contributory role in the indication for corrective surgery; because the knowledge of the vesicourethral complex state will help to stabilize it through a correct individualized medical treatment before surgical treatment, delaying or even avoiding surgery in some cases.