Bladder function development and its urodynamic evaluation in neonates and infants less than 2 years old

Abstract

Further animal and human studies will increase our understanding of bladder development leading toward mature function. UDS are still important in providing information for early bladder dysfunction in newborns and infants.

ICS educational module: Cystometry in children

“…When history and/or clinical examination have confirmed a relevant neurologic abnormality the term neurogenic detrusor overactivity is used. [1][2][3][4]13 Otherwise, idiopathic detrusor overactivity is the preferred term. 3.…”

“…In children, more than one uroflowmetry is strongly suggested to establish with certainty the necessity of an invasive study. 1,2 The child is advised to arrive at the urodynamics suite with a full bladder if possible and the examination starts with a free uroflowmetry. This is best accomplished by adequate but not excessive hydration beforehand and/or appropriate timing of a previous void so the bladder is relatively full at the time the child arrives at the urodynamics facility.…”

“…High DLPP (eg, >40 cm H2O) is usually induced by a decrease in bladder compliance and/or detrusor underactivity, is associated with upper urinary tract deterioration. 1,5 Low DLPP indicated urethral incompetence. 1,5 Techniques and evaluation are not further standardized in this document describing filling cystometry.…”

“…1,5 Low DLPP indicated urethral incompetence. 1,5 Techniques and evaluation are not further standardized in this document describing filling cystometry. 6.…”

ICS educational module: Pressure flow study in children

“…Combined with filling cystometry, it is the gold standard for evaluating voiding function in children with lower urinary tract dysfunction (LUTD)/lower urinary tract symptoms (LUTS), especially when less invasive studies fail to provide an adequate explanation for the symptoms and/or the signs of dysfunction. [1][2][3][4][5][6][7] The aim of pressure/flow studies is to reproduce symptoms, to identify the underlying causes for voiding symptoms, and to quantify related pathophysiological processes. It is used to establish as clearly as possible a baseline, so that changes resulting from treatment and/or growth can be assessed, indicating that the investigation may need to be repeated, and to provide some guidelines for the choice of treatment (although results of urodynamic testing may not necessarily be the deciding factor).…”