Urodynamic analysis of 70 children with different lower urinary tract symptoms

Abstract

Objective To explore the characteristics of urodynamic parameters of children with different lower urinary tract symptoms (LUTS) but without neurogenic or organic diseases, thus providing references for the clinical diagnosis and treatment. Method Clinical data of LUTS children without neurogenic or organic diseases who underwent urodynamic tests in the Department of Urology, Beijing Children′s Hospital of Capital Medical University from January 2017 to December 2019 were retrospectively analyzed.A total of 70 LUTS children aged 5-12 years were recruited, involving 46 males and 24 females with the median age of 9.0 (7.0, 10.0) years.According to the main symptoms of LUTS, patients were divided into 4 groups: urinary frequency and urgency group, urinary incontinence group, enuresis group and others.All children underwent urodynamic tests, including noninvasive uroflow rate/pelvic floor electromyography and urethral catheterization cystometry.Urodynamic parameters were recorded for analysis.The results of urodynamic study were compared among urinary frequency and urgency group, urinary incontinence group and enuresis group. Results There were no significant differences in the noninvasive uroflow rate and post-voiding resi-dual volume among the three groups.Contractions of pelvic floor muscles during urination in children with abnormal urine flow curve were more often observed than those with normal urine flow curve ( 17/38 cases vs.2/32 cases, χ2=13.012, P<0.05). The contractions in children with staccato-shaped curve were more often observed than those with plateau-shaped curve (13/22 cases vs.3/14 cases, χ2=36.000, P<0.05). There were no significant differences in the main invasive urodynamic parameters of storage and emptying phase among the three groups.The bladder compliance of children with detrusor overactivity (DO) was lower than those without DO [12.64(9.00, 21.11) mL/cmH2O vs.32.22(21.81, 97.75) mL/cmH2O, 1 cmH2O=0.098 kPa, Z=-26.333, P<0.001]. The maximum urethral static pressure of children with enuresis was higher than those with urinary frequency and urgency, and urinary incontinence [(120.00±20.69) cmH2O vs.(81.17±28.09) cmH2O vs.(69.59±22.19) cmH2O, F=12.170, P<0.05]. The maximum urethral closed pressure of children with enuresis was higher than those with urinary frequency and urgency, and urinary incontinence [(109.86±41.94) cmH2O vs.(62.41±26.71) cmH2O vs.(58.09±20.49) cmH2O, F=11.804, P<0.05]. Conclusions Urodynamic abnormalities are common in LUTS children without neurogenic or organic diseases.Urodynamic tests can be applied to identify the types and distributions of potential urodynamic abnormalities, and to guide the treatment and reflect curative effect.DO and decreased bladder compliance are the most common urodynamic abnormalities, which should be monitored and treated in time.