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Evaluation of the utility of video-urodynamics in children with urinary tract infection and voiding dysfunction
D B Glazier1, D P Murphy, M H Fleisher
1Division of Urology, Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
Insights
Video-urodynamic studies (VUDS) help diagnose urinary tract infections (UTI) and voiding dysfunction in children. VUDS provides crucial information for treatment selection and identifies children needing further evaluation.
Area of Science:
- Pediatric Urology
- Diagnostic Imaging
- Urodynamics
Background:
- Urinary tract infections (UTI) in children can be associated with voiding dysfunction.
- Accurate diagnosis is essential for effective treatment and preventing complications.
Purpose of the Study:
- To evaluate the utility of video-urodynamic studies (VUDS) in diagnosing children with UTI and voiding dysfunction.
- To determine if VUDS aids in treatment decisions.
Main Methods:
- A 16-month prospective study involving children with UTI and symptoms of voiding dysfunction.
- Free and pressure-flow VUDS were performed on 42 children; 38 were included in the analysis.
- Patient demographics included a mean age of 9 years, with 15 males and 23 females.
Main Results:
- All participants had a history of voiding dysfunction (mean 55 months).
- Vesicoureteral reflux was found in only 5 patients; 3 had detrusor instability.
- Of 33 patients without reflux, 24 showed urodynamic abnormalities, most commonly detrusor instability (17/24).
Conclusions:
- VUDS offers unique insights into the causes of UTI and voiding dysfunction in children.
- VUDS results guide specific treatment selection, prevent inappropriate therapies, and identify children for follow-up.
- VUDS should be considered for pediatric patients presenting with UTI and voiding dysfunction.
Objective:
To assess the use of video-urodynamic studies (VUDS) in children with urinary tract infection (UTI) and symptoms of voiding dysfunction (frequency, urgency, incontinence), to ascertain whether VUDS significantly assists in diagnosis and deciding treatment.
Patients And Methods:
Over a 16-month period, all children seen at our centre with a UTI in conjunction with previous symptoms suggestive of voiding dysfunction underwent free and pressure-flow VUDS. Forty-two children underwent VUDS and 38 (mean age 9 years, range 4-16, 15 male, 23 female) had sufficient information to be included in the study.
Results:
All children had a prior history of voiding dysfunction (mean 55 months). Only five patients were found to have reflux and three of these had associated detrusor instability. In addition, 24 of 33 patients who did not have reflux had abnormalities on urodynamic study, the most common problem being detrusor instability in 17 of 24 patients. Other abnormalities included sphincter dyssynergia (five patients), poor bladder compliance (two) and hypersensitivity on bladder filling (three).
Conclusion:
VUDS can provide information about the aetiology of UTI and voiding dysfunction in children that cannot be obtained from any other source. The results of VUDS can be used to select specific treatments, to avoid inappropriate therapy and to identify children who may benefit from follow-up studies despite normal findings on voiding cystourethrography. From these results, we believe that VUDS should be considered for children with UTI and voiding dysfunction.
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