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. 2007 Oct;23(4):435-42.
doi: 10.4103/0970-1591.36719.

A review of urodynamic evaluation in children and its role in the management of boys with posterior urethral valves

Divyesh Y Desai  1
Affiliations

A review of urodynamic evaluation in children and its role in the management of boys with posterior urethral valves

Divyesh Y Desai. Indian J Urol. 2007 Oct.

Abstract

Posterior urethral valves are the commonest cause of lower urinary tract outflow obstruction in male infants with an estimated incidence of 1:5000 male infants and 1:25,000 live births. Despite treatment with fulguration of the obstructing valves, bladder function is abnormal in up to 70% of older children and adolescents. Bladder dysfunction causes morbidity e.g. urinary incontinence and has been implicated in the late deterioration of renal function in this population. A poor understanding and inappropriate management of bladder dysfunction can result in unnecessary morbidity, which can handicap a child for life. Any method that measures function or dysfunction of the lower urinary tract constitutes a urodynamics investigation. Broadly, the investigations can be classified into simple or noninvasive urodynamics and invasive urodynamics. The objective of urodynamics assessments in children is to reproduce the patient's complaints or symptoms. Video urodynamics can provide additional information that may contribute to a further understanding of the problem under investigation. Urodynamics provides a useful tool to test the efficacy of treatment as well as determine any refinements necessary to improve the outcome of such treatment.

Keywords: Children; posterior urethral valves; urodynamic evaluation.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Natural Filling Urodynamics post valve resection in boys under two years of age Typical Features: a. Detrusor overactivity during bladder filling b. Reduced functional capacity c. High detrusor voiding pressures d. Incomplete bladder emptying
Figure 2
Figure 2
Decompensated Bladder Dynamics seen in teenage to early adult life. Typical features: a. Large capacity bladder which is stable b. Low detrusor voiding pressures c. Abdominal effort to initiate voiding d. Incomplete bladder emptying
Figure 3
Figure 3
Natural filling urodynamics
Figure 4
Figure 4
Artificial poorly compliant bladder with overactivity Can result from the following: a. Rapid rate of bladder filling b. Lowered temperature of filling solution c. Bladder overfilling beyond normal capacity
See this image and copyright information in PMC

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