ギラン・バレー症候群の子供における神経因性下部尿路機能障害の6ヶ月以内の urodynamic評価

This study aimed to evaluate urodynamic characteristics, identify high-risk and unfavorable urodynamic findings in children with neurogenic lower urinary tract dysfunction (NLUTD) secondary to Guillain-Barre syndrome (GBS) within 6 months since the onset of illness.

This study conducted a retrospective observational analysis of 16 children diagnosed with GBS complicated by NLUTD. Clinical data collected included demographic information, lower urinary tract symptoms, uroflowmetry results, post-void residual urine (PVRU), and urodynamic parameters. Follow-up assessments focused on high-risk urodynamic features-such as high detrusor pressure during the filling phase and low bladder compliance-as well as unfavorable findings, including detrusor overactivity, detrusor underactivity, or an acontractile bladder.

The majority of patients presented with clinical symptoms of urinary retention. Characterized by a decreased Qmax on uroflowmetry and elevated PVRU. Urodynamic study (UDS) revealed two predominant findings: reduced bladder sensation during the filling phase and detrusor underactivity during the voiding phase. At the 8-week follow-up, low bladder compliance and detrusor overactivity were observed in only 2 of the 16 patients (12.5%). During the filling phase, none of the patients exhibited high detrusor pressure (>40 cmH₂O), while all cases demonstrated underactive bladder function during the voiding phase. By the 24-week follow-up, 12 patients (12/16, 75.0%) had achieved normal bladder compliance, with only one case persisting with low bladder compliance and detrusor overactivity. Additionally, 10 patients (10/16, 62.5%) who had presented with an underactive bladder during the voiding phase showed recovery by the 24-week assessment.

The prognosis of autonomic dysfunction involving the urinary system in pediatric GBS was generally favorable, with most cases of GBS-associated NLUTS showing substantial reversibility, as confirmed by the normalization of urodynamic parameters over time.