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【Objective】 To analyze the results, characteristics and clinical value of video urodynamic study (VUD) of lower urinary tract symptoms (LUTS) in young male. 【Methods】 A total of 106 young male LUTS patients (18-45 years old) who received VUD in our hospital during Jan.2016 and Sep.2021 were collected to analyze the clinical and imaging urodynamic characteristics. 【Results】 Of the 106 patients, 55 (52.44%) had neurogenic lower urinary tract dysfunction (NLUTD)with clear neurological etiology, and 51 (48%) had non-neurogenic lower urinary tract dysfunction (NNLUTD). In NLUTD patients, dysuria was the most common symptom (76.74%); lumbosacral lesions were the main cause (76.36%); imaging urodynamics indicated weakening of detrusor muscle in different degrees. In NNLUTD patients,the main symptoms were frequent urination (48.72%) and dysuria (48.72%); about 58.97% of patients had two or more LUTS, and the main diagnosis was detrusor underactivity (DU)(35.90%). 【Conclusion】 NLUTD in young male is characterized by varying degrees of detrusor muscle weakness, detrusor sphincter dyscoordination, and decreased bladder compliance. NNLUTD is mostly caused by detrusor overactivity (DO) and DU.
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Objective To explore the relationship between congenital vesical ureteral reflux(VUR) and bladder dysfunction in children through videourodynamic examination.Methods Sixty-seven children with congenital VUR in the First Affiliated Hospital of Zhengzhou University from Apr.2011 to Jul.2013 were included,and their clinical information of urnary tract infection,detrusor activity,dysfunctional voiding and grade of VUR were recorded.All the children were categorized as normal,isolated detrusor overactivity (DO)and dysfunctional voiding (DV) (with or without DO) according to the manifestation of urodynamic patterns,who were also divided into groups of low grade (Ⅰ-Ⅱ) VUR or high grade (Ⅲ-Ⅴ) VUR.Data of video-urodynamic examination,urinalysis,and voiding cystourethrogram were collected to investigate the relationship between bladder dysfunction,sides and grade of VUR and urinary tract infection.Results Totally 73.1％ (49/67 cases) of children with VUR were found having bladder dysfunction,which consisted of 49.3％ (33/49 cases) of DO,23.8％ (16/49 cases) of DV.Children with isolated DO tended to manifest unilateral,low grade reflux (grade Ⅰ-Ⅱ) with less urinary infection.However,children with DV,isolated or combined with DO manifest bilateral,high grade reflux(grade Ⅲ-Ⅳ),and often with urinary infection.Conclusions Video urodynamic study is useful for evaluation of bladder function in children with VUR,which is important in management of VUR.
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PURPOSE: Voiding dysfunction is known to affect on the result of treatment for vesicoureteral reflux(VUR) in children. The aim of this study is to find out specific urodynamic abnormality in the children with VUR and voiding dysfunction. MATERIALS AND METHODS: We evaluated 16 children having VUR with voiding dysfunction symptoms. Voiding symptoms were frequency, urgency, urge incontinence, nocturnal enuresis and voiding postponement. An awake video-urodynamic study(video-UDS) was performed without anesthesia. RESULTS: Urodynamic abnormalities were found in 11 children(69%). The most common urodynamic abnormality was uninhibited detrusor contraction(10 cases, 63%), and 8 of these patients had urgency and/or urge incontinence. Other urodynamic abnormalities were small maximum cystometric capacity(5 cases, 31%), and detrusor sphincter dyssynergia(DSD)(3 cases, 19%). All the children with DSD had voiding postponement. VUR was found in 8 children(50%) during video-UDS. Among the urodynamic parameters small cystometric bladder capacity was found to be a most significant factor in predicting low Pressure VUR(sensitivity 100%, specificity 100%, p=0.018). CONCLUSIONS: These results suggest that abnormal detrusor activity is more frequent than abnormal coordination between detrusor and external sphincter activity in the children with VUR and voiding dysfunction symptoms. And small maximum cystometric capacity seems to be a significant urodynamic parameter for perpetuating VUR in these children.