Role of Urodynamics in Paediatric Patients with Spina Bifida: Retrospective Study
DOI:
https://doi.org/10.25759/spmfr.248Keywords:
Child, Urinary Bladder, Neurogenic, Spinal Dysraphism, UrodynamicsAbstract
Introduction: Neurogenic bladder is commonly found in patients with spina bifida and is associated with an increased risk of nephropathy and renal failure. We evaluated the importance of performing urodynamic studies in the diagnosis and control of vesico-sphincter dysfunction.
Material and Methods: Retrospective, descriptive, inferential study of patients followed in a spina bifida consultation between 2011 and 2013. Data was analyzed with Epi Info™ and SPSS®.
Results: We studied 96 patients with a mean age of 14 years. Neurogenic bladder was present in 94 patients, a quarter of these had recurrent urinary tract infections. At the time of the first urodynamic studies, 56% were spontaneous emptiers having 50% low age-related bladder capacity and 70% overactive detrusor. It was suggested the introduction of intermittent catheterization in 12%, anticholinergic drug therapy in 44% and both in 39% of the cases. After the first urodynamic study, the anticholinergic drug therapy outcomes were: 27% increased bladder capacity to normal values, 30% gained regular bladder compliance (p=0.031), 60% had no more terminal detrusor hypertonia (p=0.004) and 40% had no more detrusor overactivity (p=0.004). In patients to whom intermittent catheterization were added to anticholinergic drug treatment the outcomes were the following: 57% increased bladder capacity to normal values (p=0.039) , 32% improved bladder compliance, 63% had no more terminal detrusor hypertonia (p=0.039) and 53% had no more detrusor overactivity (p=0.012).
Conclusion: Urodynamic studies are crucial in the assessment of bladder behavior, allowing introduction, adjustment, and evaluation of therapeutic measures.
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