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Year : 1999  |  Volume : 15  |  Issue : 1  |  Page : 37-41

Urodynamic assessment of patients with posterior urethral valves.

Department of Urology, BYL Nair Ch. Hospital, Mumbai

Correspondence Address:
M D Sanzgiri
Department of Urology, BYL Nair Ch. Hospital, Mumbai

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Source of Support: None, Conflict of Interest: None

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Objective : To identify the indications for urodynamic studies. To assess and categorise type of bladder dysfunction. To achieve a correlation between symptoms and urodynamic patterns. Patients and Methods : This is a prospective study carried out between August 1996 and January 1998 in a single tertiary referral urological unit including 72 patients with posterior urethral valves. These patients included 8 asymptomatic controls and 64 consecutive patients referred with symptoms of obstruction, incontinence or deteriorating renal function. All these patients were a minimum of 6 months post fulguration and did not have any radiological or endoscopic evidence of obstruction. The urodynamic evaluation was carried out on a DANTEC 5500 Urodynamic apparatus. The evaluation included a complete cystometric study and sphincter electromyography. Analysis: The urodynamic findings were recorded and analysed. The cystometric capacity, the compliance, the detrusor stability during filling cystometry, the detrusor contractility during the voluntary voiding phase and the EMG pattern were recorded. On the basis of these findings patients were categorised into broad urodynamic patterns. These patterns were then correlated with the presenting symptoms. Results : The majority of our patients were between 3 and 10 years of age (Table-1). Out of 72 patients, 8 were asymptomatic (controls), 35 presented with incontinence, 28 with obstructive symptoms and 1 with deteriorating renal function (Table-2). On clinical correlation it was observed that out of 28 patients who presented with incontinence 12 were low compliant out of which 8 had an unstable detrusor (presented with urge incontinence) and 16 were high compliant with a hypocontractile detrusor (presented with overflow incontinence). Of the 35 patients who had presented with obstructive symptoms all were hypocontractile (Table-6).All the asymptomatic patients had a normal urodynamic pattern. There were overall 4 different patterns of bladder dysfunction (not mutually exclusive); 10 were unstable, 25 were small capacity, 24 were low compliant and 40 were hypocontractile (Table-5).

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