[Cystomanometric investigations in children with enuresis and chronic urinary tract infection (author's transl)]

Abstract

Ninety one patients with urinary tract infection, infection with enuresis or enuresis alone, but without any malformation of the lower urinary tract have been examined clinically as well as by cystomanometric und uroflow-metric studies. It could be shown that the most important parameters to evaluate blader function were the bladder compliance and the detrusor contraction during the filling of the bladder. The bladder compliance was estimated from the volume pressure relationship under resting conditions, at the first urgency to voide and at the moment when the maximal bladder capacity was reached, Concerning the detrusor contraction we distinguished partial isovolumetric detrusor contractions with an amplitude of 1--8 mm Hg and uninhibited detrusor contractions with an amplitude of more than 10 mm Hg. According to these two parameters it was possible to differentiate cystomanometrically seven different types of irritable and non irritable bladder, and to introduce a new theory of the pathogenesis of enuresis. According to this theory we suppose that enuresis in childhood is mostly caused by neurovegetative psychogenic disorders similar to anorectal sphincter achalasia in patients with overflow encopresis.