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Four-hour voiding observation in young boys with posterior urethral valves
G Holmdahl1, E Hanson, M Hanson
1Department of Pediatric Surgery, Children's Hospital, Göteborg, Sweden.
Insights
Four-hour voiding observation effectively identifies bladder emptying issues in young boys with posterior urethral valves (PUV). This noninvasive method aids in diagnosing and managing PUV-related bladder dysfunction.
Area of Science:
- Pediatric Urology
- Diagnostic Methods in Urology
- Voiding Dysfunction
Background:
- Posterior urethral valves (PUV) are a common cause of bladder outlet obstruction in male infants.
- Early diagnosis and management of PUV are crucial to prevent long-term renal damage and bladder dysfunction.
- Assessing bladder function in very young children presents diagnostic challenges.
Purpose of the Study:
- To evaluate the utility of a 4-hour voiding observation as a noninvasive method for assessing bladder dysfunction in young boys with PUV.
- To compare the diagnostic accuracy of voiding observation with standard cystometry.
Main Methods:
- A noninvasive 4-hour voiding observation was conducted in 24 boys younger than 4 years with PUV.
- Parameters assessed included voiding frequency, voided volume, residual urine volume, and bladder capacity.
- Data were compared to age-matched healthy controls and standard cystometry findings.
Main Results:
- Boys with PUV exhibited a higher voiding frequency, smaller voided volumes, and higher residual urine volumes compared to controls.
- Voiding patterns did not significantly change after surgical correction of the PUV.
- Standard cystometry yielded higher values for voided volume, residual urine volume, and bladder capacity than voiding observation.
Conclusions:
- Four-hour voiding observation is a simple, noninvasive tool for detecting emptying difficulties in boys with PUV.
- This method clearly differentiates voiding patterns between boys with PUV and healthy children.
- Voiding observation is recommended as a complementary diagnostic tool to standard cystometry for managing bladder dysfunction in young boys with PUV.
Purpose:
We evaluated 4-hour voiding observation as a method of basic assessment of bladder dysfunction in young boys with posterior urethral valves.
Materials And Methods:
Voiding pattern, including number of voids, voided and residual urine volume, and bladder capacity, was determined noninvasively in 24 boys younger than 4 years with posterior urethral valves and compared to that of healthy age matched controls. Results were then compared to those of standard cystometry.
Results:
The number of voids was higher, voided volume was smaller and residual urine volume was higher in the posterior urethral valve group. There was no difference in voiding pattern before and after removal of the anatomical obstruction. Voided and residual urine volume, and bladder capacity were higher on standard cystometry than on voiding observation.
Conclusions:
Four-hour voiding observation is an easy noninvasive method that focuses on emptying difficulties and clearly detects differences in voiding patterns between boys with posterior urethral valves and healthy, nontoilet trained children. We recommend the method as a complement to standard cystometry for the diagnosis and followup of bladder dysfunction in young boys with posterior urethral valves to identify the need for treatment.