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Urodynamic pattern in infants with urinary tract infection
M Bachelard1, U Sillén, S Hansson
1Department of Pediatric Radiology, Children's Hospital, Göteborg, Sweden.
Insights
Infants with urinary tract infections often show bladder instability and hypercontractility. This bladder dysfunction appears to be influenced by the infection, with effects potentially lessening over time.
Area of Science:
- Pediatric Urology
- Pediatric Nephrology
- Urodynamics
Background:
- Urinary tract infections (UTIs) are common in infants.
- Urodynamic patterns in infants with UTIs require further investigation.
- Understanding the impact of UTIs on infant bladder function is crucial.
Purpose of the Study:
- To investigate the urodynamic patterns in infants diagnosed with their first urinary tract infection.
- To assess the influence of the urinary tract infection on infant bladder function.
Main Methods:
- Video cystometry, combining cystometry and voiding cystourethrography, was performed.
- The study included 90 male and 68 female infants hospitalized for their first UTI.
- Urodynamic evaluations were conducted at two intervals: 1-30 days and 32-78 days post-diagnosis.
Main Results:
- Bladder instability was observed in approximately two-thirds of both male and female infants.
- Male infants exhibited high voiding detrusor pressure and low bladder capacity (hypercontractility) compared to older children.
- Female infants also showed increased voiding pressures, though lower than males; pressures were higher when evaluation was delayed post-infection.
Conclusions:
- Infants with UTIs demonstrate bladder instability and hypercontractility, differing from older children.
- Bladder hypercontractility was less pronounced in the early stages post-infection, suggesting potential inhibition by infectious agents.
- Further urodynamic studies in healthy infants are needed to differentiate normal infantile patterns from potential bladder dysfunction.
Purpose:
We studied the urodynamic pattern in infants with urinary tract infection and evaluated the influence of the infection.
Materials And Methods:
Cystometry was combined with voiding cystourethrography (video cystometry) in 90 male and 68 female infants admitted to the hospital with first time urinary tract infection. Evaluation was performed 1 to 30 days (mean 11) and 32 to 78 days (mean 46) after diagnosis in 93 and 65 infants, respectively.
Results:
Bladder instability was found in two-thirds of male and female infants. Compared to older children male infants had high voiding detrusor pressure and low bladder capacity (hypercontractility). Female infants also had increased voiding pressure levels but they were significantly lower than those in male infants. The voiding detrusor pressure was even higher in both sexes when evaluation was delayed after the infection.
Conclusions:
Infants with urinary tract infection have bladder instability and hypercontractility compared to older children. Bladder hypercontractility was less pronounced early after infection, suggesting that the infectious agents inhibit detrusor muscle contractility. Whether hypercontractility is a normal urodynamic pattern in infancy or represents bladder dysfunction can only be addressed by urodynamic studies of healthy infants.