Diagnostic value of natural fill cystometry in neurogenic bladder in children

Investigation of the diagnostic value of natural fill cystometry (NFC) in children with neurogenic bladder in comparison to conventional videocystometry (CVC).

We investigated 20 children (aged 6-11; 15 girls and 5 boys) with the following diagnoses: 6 myelomeningocele, 2 tethered cord syndrome, 1 syringomyelia, 1 Vater syndrome, 1 suprasacral spinal cord injury, 9 suspected neurogenic bladder. We carried out a NFC after completing standard diagnostic including a slow-filling CVC.

All investigations were completed successfully. The investigation lasted 6-20.5 h (mean 11:15 h). We registered phases of sleep, waking consciousness and micturition. CVC findings were confirmed in 45%: normal bladder function was confirmed in 2 patients (10%), bladder hyperactivity was confirmed in 7 patients (35%). In 55% we obtained different findings on NFC in comparison to the slow-filling CVC: bladder hyperactivity was not confirmed in 2 (10%), detection of bladder hyperactivity was found in 4 children (20%) with normal bladder function on CVC, detection of bladder hyperactivity on NFC was found in 5 children (25%) with low-compliance bladder on CVC. In 45% of all children, NFC detected new findings compared with CVC diagnoses. In 10%, possible artifacts (e.g. due to catheterization) of CVC were recognized. CVC findings were confirmed in 45%.

These results are preliminary but they suggest that this is a new diagnostic method for improving the diagnostic standard in the childhood neurogenic bladder.