ABSTRACT
PURPOSE: Intravesical electrical stimulation (IVES) has been performed at the Severance Hospital for various purposes in children with voiding difficulty due to neurogenic or non-neurogenic causes. The effect of IVES in children with infrequent voider syndrome is controversial. The aim of this study was to investigate the effect of IVES in children with infrequent voider syndrome. MATERIALS AND METHODS: Between September 1999 and August 2001, 12 children diagnosed with infrequent voider syndrome, who received IVES at the Severance Hospital, were retrospectively analyzed. We investigated the changes in abdominal straining voiding, a voiding interval more than 8 hours, urgency and overflow incontinence after IVES. We also compared the uroflowmetry curve, maximal urine flow rate, maximal detrusor contraction pressure and residual urine volume after IVES. RESULTS: Abdominal straining voiding, a voiding interval more than 8 hours, urgency and overflow incontinence were decreased from 83.3 to 25.0%, 50.0 to 16.7%, 25.0 to 0% and 58.3 to 25.0%, respectively. After IVES, fractionated voiding and flat-shape voiding were decreased from 66.7 to 16.7% and 33.3 to 8.3%, respectively. Whereas, bell-shape voiding was increased from 0 to 75.0%. The maximal urine flow rate was increased significantly, from 5.6 3.7 to 11.2 4.2m/s (p=0.002), but the residual urine volume was decreased significantly, from 71.7 47.5 to 9.2 13.8ml (p=0.0001). The maximal detrusor contraction pressure was increased in some children. CONCLUSIONS: The maximal urine flow rate was significantly increased after IVES in children with infrequent voider syndrome, but the residual urine volume was decreased significantly. There was a significant treatment effect in flat-voiding children, leading to the conclusion that IVES can be particularly effective in this specific group of children with infrequent voider syndrome.
Subject(s)
Child , Humans , Electric Stimulation , Retrospective Studies , Urination Disorders , UrodynamicsABSTRACT
PURPOSE: Vesicoureteral reflux (VUR) in a transplanted kidney may affect the function of a grafted kidney with a recurrent urinary tract infection (UTI), and is a factor of graft failure. Our experience of surgical correction was investigated by performing transvesical ureteral reimplantation in VUR recipients. MATERIALS AND METHODS: Among 2,265 recipients, who had received a living kidney transplantation at Yonsei University Severance Hospital between April 1979 and October 2003, and 29 VUR recipients (7 Men, 22 Women), diagnosed with VCUG after recurrent UTI, were retrospectively analyzed. The mean age of the patients was 43.9, ranging from 24 to 61 years, with a mean follow up of 3.6, ranging from 0.7 to 8.0 years. The changes in the serum creatinine and complications after a transvesical ureteral reimplantation were analyzed. RESULTS: The incidence of VUR was 1.28% (29/2,265) and the mean diagnosis was made after 5.0, ranging from 0.8 to 13.4 years. The grades of VUR were 2 (I), 2 (II), 20 (III) and 5 (IV). Twenty-five recipients underwent a transvesical ureteral reimplantation. The mean serum creatinine decreased from 2.5+/-2.2 to 1.8+/-1.4mg/dl (p=0.14) 1 year after surgical correction, and was significantly decreased from 2.5+/-2.2 to 1.4+/-0.7mg/dl (p=0.017) 3 years after surgical correction. There were no UTI and acute pyelonephritis after a ureteral reimplantation. CONCLUSIONS: VUR, with recurrent UTI, in recipients administered an immunosuppressive agent may cause deterioration of the graft function. The suspicion of VUR should be borne in mind for renal recipients with recurrent UTI, which can be safely corrected by a transvesical ureteral reimplantation.