Is It Necessary to Repeat Videourodynamic Studies on Spina Bifida Children?

Hyun Jin Jung; Myung Joo Kim; Young Jae Im; Chang Hee Hong; Sang Won Han

doi:10.4111/kju.2009.50.10.1018

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Jung, Kim, Im, Hong, and Han: Is It Necessary to Repeat Videourodynamic Studies on Spina Bifida Children?

Original Article

Korean J Urol 2009;50(10):1018-1021.

Published online: 19 October 2009

DOI: https://doi.org/10.4111/kju.2009.50.10.1018

Is It Necessary to Repeat Videourodynamic Studies on Spina Bifida Children?

Hyun Jin Jung, Myung Joo Kim, Young Jae Im, Chang Hee Hong, Sang Won Han

From the Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea

Correspondence to: Sang Won Han Chief Director of Pediatric Urology, Professor of Urology, Yonsei University College of Medicine, 134, Shinchon-dong, Seodaemun-gu, Seoul 120-752, Korea TEL: 02-2228-2316 FAX: 02-312-2538 E-mail: swhan@yuhs.ac

Received 23 June 2009 Accepted 23 September 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

A videourodynamic study is useful for examining the functional and structural problems of the urinary tract simultaneously. Due to its invasiveness, however, it is important to obtain as much information as is possible as the study is being conducted. The purpose of this study was to evaluate the results of a repeated videourodynamic examination in spina bifida children.

Materials and Methods

Between January 2005 and July 2006, a total of 48 patients who were diagnosed with spina bifida and underwent repeated videourodynamic studies were enrolled in this study. We compared variables including compliance, involuntary detrusor contraction (IDC), cystometric bladder capacity (CBC), maximum detrusor pressure, and post-voiding residual urine (PVR) between the initial and repeated studies.

Results

During the repeated studies, cases of IDC decreased significantly (p＜0.05) compared with the initial studies. No other significant differences were found in terms of compliance, CBC, maximum detrusor pressure, and PVR.

Conclusions

There were no significant differences in terms of compliance, CBC, maximum detrusor pressure, and PVR between initial and repeated studies. However, the number of patients who had IDC decreased significantly in the second study. Nevertheless, we conclude that the first examination in this study was enough to evaluate the overall function and structure of the urinary tract. We believe that repeat studies are not necessary in children with spina bifida.

Keywords: Spinal dysraphism, Overactive urinary bladder, Urodynamics, Child

REFERENCES

1.Madersbacher H. Video urodynamics. World J Urol. 1988. 6:14–7.

2.Glazier DB., Murphy DP., Fleisher MH., Cummings KB., Barone JG. Evaluation of the utility of video-urodynamics in children with urinary tract infection and voiding dysfunction. Br J Urol. 1997. 80:806–8.

3.Hoebeke P., Van Laecke E., Van Camp C., Raes A., Van De Walle J. One thousand video-urodynamic studies in children with non-neurogenic bladder sphincter dysfunction. BJU Int. 2001. 87:575–80.

4.Neveus T., von Gontard A., Hoebeke P., Hjälmas K., Bauer S., Bower W, et al. The standardization of terminology of lower urinary tract function in children and adolescents: report from the Standardisation Committee of the International Children's Continence Society. J Urol. 2006. 176:314–24.

5.Scholtmeijer RJ., Griffiths DJ. The role of videourodynamic studies in diagnosis and treatment of vesicoureteral reflux. J Pediatr Surg. 1990. 25:669–71.

6.Borzyskowski M., Mundy AR. Videourodynamic assessment of diurnal urinary incontinence. Arch Dis Child. 1987. 62:128–31.

7.Lee SW., Kim KM. Rectus fascial sling for treating neurogenic sphincteric incontinence in boys with spina bifida. Korean J Urol. 2004. 45:1258–62.

8.Jung JH., Kim HW., Kim JW., Kim MJ., Kim CS., Jeon HJ, et al. When should videourodynamic study be performed after correcting the defect in patients with myelodysplasia? Korean J Urol. 2006. 47:522–6.

9.Mayo ME., Burns MW. Urodynamic studies in children who wet. Br J Urol. 1990. 65:641–5.

10.Norgaard JP., van Gool JD., Hjälmas K., Djurhuus JC., Hellström AL. Standardization and definitions in lower urinary tract dysfunction in children. International Children's Continence Society. Br J Urol. 1998. 81(Suppl 3):1–16.

11.Chin-Peuckert L., Komlos M., Rennick JE., Jednak R., Capolicchio JP., Salle JL. What is the variability between 2 consecutive cystometries in the same child? J Urol. 2003. 170:1614–7.

12.Poulsen EU., Kirkeby HJ., Djurhuus JC. Short- and long-term reproducibility of cystometry. Urol Res. 1989. 17:197–8.

13.Lorenzo AJ., Wallis MC., Cook A., Buffett-Fairen A., Bozic D., Bägli DJ, et al. What is the variability in urodynamic parameters with position change in children? Analysis of a prospectively enrolled cohort. J Urol. 2007. 178:2567–70.

Table 1.

Patients characteristics

	Total	MMC		LMMC		Teratoma
	Total	Male	Female	Male	Female	Male
No. of patients (n)	48	9	9	19	10	1
Mean age (years)	7.31	8.89	10.11	7.47	3.7	1
(range)	(0-19)	(3-17)	(1-19)	(0-19)	(0-8)
Other abnormalities
Cardiac problems (n)	2			2
Anorectal problems (n)	5	1		4
PUV (n)	1	1
Hypospadias (n)	2			2
Voiding pattern
CIC (n)	29	7	8	11	3
Self voiding (n)	19	2	1	8	7	1
Urgency & urge incontinence (n)	7	1	2	3	1

MMC: meningomyelocele, LMMC: lipomeningomyelocele, PUV: posterior urethral valve, CIC: clean intermittent catheterization

Table 2.

Videourodynamic parameters

	1st study	2nd study	p-value
Compliance (n)			0.2482^a
Normal (%)	23 (47.9)	27 (56.2)
Decreased (%)	25 (52.1)	21 (43.8)
IDC (n)			0.0077^a
Yes (%)	12 (25.0)	3 (6.3)
No (%)	36 (75.0)	45 (93.7)
CBC (ml)	194.15±127.34	201.85±128.37	0.079^b
(% of EBC)	(84.83±30.24)	(89.52±27.69)	(0.238^b)
MaxPdet (cmH₂O)	57.69±45.14	57.71±34.63	0.996^b
PVR (ml)	119.29±125.59	121.77±129.65	0.268^b
(% of CBC)	(50.57±33.10)	(52.53±34.93)	(0.445^b)

IDC: involuntary detrusor contraction, CBC: cystometic bladder capacity, EBC: expected bladder capacity, MaxPdet: maximum detrusor pressure, PVR: post voiding residual urine

^a : McNemar’s test,

^b : paired t-test

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