The urodynamic study of neurogenic bladder with vesicoureteral reflux / 实用医学杂志

ABSTRACT

Objective In children with neurogenic bladder and secondary vesicoureteral reflux , we ex-plore the differences of urodynamics between the children with and without detrusor overactivity (DO). The study is in order to provide theoretical support for clinical practice. Method From January 2013 to March 2016, 110 children with NB vesicoureteral reflux diagnosed by videourodynamics were recruited. There are 63 boys and 47 girls aged 4-12 years with mean of 7.5 years. According to presence of DO during the filling phase, the patients were divided into DO (n=32) and non-DO groups (n=78). The time of bladder ureter reflux perfusion and detru-sor pressure were recorded for calculation of bladder compliance when the reflux occurs in the two groups. Maximum cystometry capacity and maximum detrusor pressure were recorded for calculation of the bladder compliance at the end of filling in the two groups. According to the reflux flow level, patients were divided into mild reflux (Ⅰ-Ⅱdegrees), severe reflux (Ⅲ-Ⅴdegrees). The difference of reflux side of the two groups and reflux degree were an-alyzed. Result In DO group, bladder capacity and compliance were (107.5 ± 21.3) mL and (5.6 ± 1.8) mL/cmH2O, respectively, when bladder ureter reflux occurs. In non-DO group, the bladder ureter reflux bladder capac-ity and compliance were (124.7 ± 35.6) mL, (6.7 ± 2.3) mL/cmH2O. The two parameters were significantly differ-ent in both groups. In DO and non-DO groups, the detrusor pressure were (21.7 ± 8.3) cmH2O and (19.6 ± 9.2) cmH2O, respectively, which does not have any significant statistical difference. At the end of filling, bladder capac-ity and compliance in DO group were (198.7 ± 36.5) mL, (5.8 ± 1.9) mL/cmH2O. In non-DO group, bladder ca-pacity and compliance were (223.8 ± 40.2) mL and (6.5 ± 1.4)mL/cmH2O. In both group, there are difference. In DO group, there are 20 cases of unilateral reflux (63%) and 12 cases of bilateral reflux (37%). In non-DO group, there are 31 cases of unilateral reflux (40%) and 47 cases of bilateral reflux (60%). The reflux of the two groups are also serious. Conclusion Small bladder capacity and poor bladder compliance are the urodynamic characteris-tics of children with NB and secondary vesicoureteral reflux when DO occurs.