The Application Of Synchronous Urethro-Cystometry In Children With Overactive Bladder

BackgroundUrodynamics has important value in diagnosis and treatment in overactive bladder. But for some patients. the results of urodynamics examination show no obvious abnormalities. Routine urodynamics does not include urethral function test. There were fewer relevant researches about urethral function. ObjectiveTo explore the application of synchronous urethro-cystometry in the diagnosis and treatment of overactive bladder in children and the value of urethral instability(URI) in OAB. MethodsRetrospective analysis of the results of urodynamics of 109 children with OAB and 23 cases of non-OAB children and the OAB symptom score in our hospital urodynamics center. OAB group included 41 males and 68 females(with an average of 8.5± 1.1 years), while non-OAB group included 10 males and 13 females(with an average of 8.2±1.3 years). Among the children with OAB, there were 62 cases of urge urinary incontinence(UUI) and 47 cases of non-urge urinary incontinence(non-UUI). URI was defined as below: during bladder filling, maximum urethral pressure decreased >15cmH2O, or ? 15cmH2 O,in the absence of detrusor overactivity(DO), but the sense of urgency appeared. SPSS 15.0 was used for statistical analysis. There were statistically differences if P value < 0.05. ResultsIn 109 children with OAB, isolated detrusor overactivity(DO) occured in 58 cases, isolated urethral instability(URI) occured in 12 cases, DO+URI occurred in 37 cases, non-DO and non-URI in 2 cases. There were no DO in 23 cases of non-OAB group, URI appeared in only 1 case. When DO was used to diagnose OAB, sensitivity was 87.2%, specificity was 100%, Youden index was 0.872. When DO and / or URI was used, sensitivity was 98.2%, specificity was 95.7%, Youden index was 0.939. The occurrence of URI in children with OAB and non-OAB groups was statistically significant. In the two groups of UUI and non-UUI, the prevalence of URI was of statistically significant difference. The average OABSS of 49 cases of URI was 10.8 ±2.1, while the average of 60 cases of non-URI was 7.2±1.9. There was statistical significance between URI and non-URI groups of children with OABSS difference. ConclusionsThe results of the study indicate that URI is associated with OAB, and urge urinary incontinence. DO combined with URI can improve the diagnostic accuracy of OAB. The appearance of URI in children with OAB may imply severe symptoms. synchronous urethro-cystometry is recommended for children with OAB.