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[Vesico-ureteral reflux associated with detrusor instability]
J E Batista Miranda1, R Regalado Pareja, J M Garat Barredo
1Unidad de Urodinamia, Servicio de Urología, Fundación Puigvert, Barcelona.
Anales Espanoles De Pediatria
|March 14, 1998
Summary
Vesico-ureteral reflux (VUR) and detrusor instability (DI) in children did not show a link between VUR severity and bladder capacity. Bilateral reflux increased upper tract damage risk.
Area of Science:
- Pediatric Urology
- Nephrology
- Pediatric Nephrology
Background:
- Recurrent urinary tract infections (UTIs) are common in children with vesico-ureteral reflux (VUR) and detrusor instability (DI).
- Urodynamic assessment is crucial for understanding bladder function in these pediatric patients.
Purpose of the Study:
- To investigate the urodynamic characteristics of pediatric patients diagnosed with both VUR and DI.
- To explore the relationship between VUR severity, bladder capacity, and upper tract damage.
- To identify risk factors for upper tract damage in this patient cohort.
Main Methods:
- A retrospective review of 24 pediatric patients (ages 4-18) with simultaneous VUR and DI diagnoses.
- Urodynamic and cystographic findings were analyzed, alongside voiding cystourethrogram (VCUG) for VUR grading.
- Follow-up included assessment of bladder capacity, compliance, and upper tract status via imaging and renography.
Main Results:
- A significant reduction in age-adjusted bladder capacity (≥15%) was observed in most patients.
- No correlation was found between VUR severity and reduced bladder capacity or compliance.
- Upper tract damage was more frequent in patients with bilateral VUR, particularly with sustained detrusor instability.
Conclusions:
- The severity of VUR does not appear to influence bladder capacity or compliance in pediatric patients with coexisting DI.
- Risk factors for upper tract damage in this study differ from those reported in other research, highlighting the complexity of VUR and DI management.