Urodynamic Analysis Of Non-neurogenic Lower Urinary Tract Dysfunction In Children

Objective: To analyze the urodynamic results of children with non-neurogenic voiding dysfunction and to examine the clinical significance of urodynamic test in the diagnosis of non-neurogenic voiding dysfunction in children.Methods: We reviewed data of children with non-neurogenic voiding dysfunction who underwent urodynamic testing from November 2015 to March 2017 in our urodynamic examination room.A neurological disorder was excluded by a detailed physical examination,medical history laboratory and imaging testing was used to confirm the absence of neurologic dysfunction.The analyzed urodynamic data include maximum flow rate,urinary flow time,voiding pattern,residual urine,first sensational volume,maximum cystometric capacity and bladder compliance,voiding detrusor pressure,existence or absence of detrusor overactivity,existence or absence of detrusor sphincter dysnergia,static urethral pressure and urethral closure pressure.Results: A total of 22 children with non-neurogenic voiding dysfunction included 16 male and 6female with mean age of 7.86±3.66 years(range: 2-14 years)were enrolled in this study.The maximum flow rate was 14.69±7.59 ml/s and32.2±12.3 ml/s for male and female,respectively(P<0.05).The average urinary flow time was 20.72±11.96 s and 12.68±7.36 s for male and female,respectively(P<0.05).The figures of maximum flow rate in Group among urinary frequency and urgency,enuresis and urinary incontinence and dysuria were demonstrated different(P<0.05).The voiding pattern indicated normal bell-shaped curve,intermittent curve,flattened curve and intermittent flattened curve in 10,4,7 and 1patients,respectively.In the determination of bladder pressure during filling,detrusor overactivity,decreased bladder compliance,decreased cystometric capacity and almost normal were observed in 6,1,3and 12 patients,respectively.In pressure-flowrate measurement,no urine flow,detrusor sphincter dysnergia,increased detrusor pressure,decreased detrusor pressure and almost normal was observed in3,1,4,2and12 patients,respectively.Conclusion: Non-neurogenic voiding dysfunction is a common disease in children characterized by complex etiology and diverse clinical manifestions.The urodynamic test can provide objective evidence for the differential diagnosis,govern the choice of therapy and allows postoperative objective follow-up in any type of voiding dysfunction.While children can usually not cooperate to perform pressure-flow study,judgment of the types and treatment assistance of voiding dysfunction can be preliminary determined with the measurements of free urine flow rate,voiding patterns and residual urine,plus a history taking.