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What volume can a child normally store in the bladder at a safe pressure?
A M Houle1, R F Gilmour, B M Churchill
1Department of Surgery (Division of Urology), Hospital for Sick Children, Toronto, Ontario, Canada.
Insights
Children can store 98.1% of their total bladder capacity at pressures below 20 cm. water, crucial for understanding normal pediatric bladder function and storage. This finding aids in assessing bladder health in children.
Area of Science:
- Pediatric Urology
- Urodynamics
- Pediatric Nephrology
Background:
- Assessing normal bladder volume storage at safe pressures is vital for pediatric urological health.
- Previous studies lacked comprehensive data on bladder storage capacity relative to pressure in children.
Purpose of the Study:
- To establish normal bladder storage volumes at safe detrusor pressures in children.
- To propose criteria for evaluating bladder storage characteristics in pediatric patients.
Main Methods:
- Reviewed 923 pediatric urodynamic studies, focusing on 69 normal examinations in children (17 boys, 52 girls).
- Performed continuous intermediate flow water cystometrograms to measure total bladder capacity, resting pressures, and volume stored at specific detrusor pressures.
- Calculated patient ages and body surface areas to analyze storage capacity independently of these factors.
Main Results:
- Over 95% of children could store 98.1% of their total bladder capacity at detrusor pressures < 20 cm. water.
- 99.9% of total bladder capacity was storable at detrusor pressures < 30 cm. water, irrespective of age or body surface area.
- A formula for minimal acceptable total bladder capacity was derived: 16(age) + 70 ml.
Conclusions:
- Children can safely store a significant majority of their bladder volume at low detrusor pressures.
- The findings provide objective criteria for assessing normal bladder storage function in pediatric urodynamics.
- Established parameters can aid in diagnosing and managing conditions affecting bladder storage in children.
Abstract:
To determine what volume a child can normally store in the bladder at a safe pressure 923 pediatric urodynamic studies were reviewed, and 69 examinations done on 17 boys and 52 girls were considered normal. Patient ages were recorded and body surface areas were calculated. A continuous intermediate flow water cystometrogram had been performed. Total bladder capacity in milliliters, full resting pressures (cm. water), and the volumes (milliliters) and percentages of the total bladder capacity stored at detrusor pressures of less than 10, 20, 30 and 35 cm. water were measured. We found that 98.1% of the total bladder capacity could be stored at a detrusor pressure of less than 20 cm. water in more than 95% of the children independently of age or body surface area and 99.9% could be stored at a detrusor pressure of less than 30 cm. water. An approximation of the minimal acceptable total bladder capacity for age can be calculated by 16(age) + 70 in ml. According to our results, we proposed criteria for good storage characteristics of the bladder in children.