The Swedish Infant High-grade Reflux Trial – Bladder function

Nordenström, Josefin; Sillén, Ulla; Holmdahl, Gundela; Linnér, Tina; Stokland, Eira; Sjöström, Sofia

doi:10.1016/j.jpurol.2016.10.022

Cited by 8 publications

(12 citation statements)

References 23 publications

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“…In contrast to these observations, one proportion of infants, preferable boys with bilateral VUR grade V mentioned in the previous section, seem to have a large BC already from the start. Whether it is the high volume load from the refluxing urine that affects the bladder and causes the abnormal increase in BC, noted in infants with hVUR, was one of the research questions in the present study [39].…”

Section: Lutd/bbdmentioning

confidence: 94%

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The Swedish infant high-grade reflux trial: Study presentation and vesicoureteral reflux outcome

Nordenström

Holmdahl

Brandström

et al. 2016

Journal of Pediatric Urology

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Section: Lutd/bbdmentioning

confidence: 94%

“…When analysing the bladder variables compared with VUR grade, independent of treatment group, PVR at baseline was significantly lower in the group with VUR resolution, compared with the non-resolution group (p=0.010) [39].…”

Section: Bladder Functionmentioning

confidence: 95%

The Swedish infant high-grade reflux trial: Study presentation and vesicoureteral reflux outcome

Nordenström

Holmdahl

Brandström

et al. 2016

Journal of Pediatric Urology

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“…At our institution, it is not routine to subject children to invasive urodynamic study on first presentation; however, we would perform the test if they failed conservative urotherapy or medical therapy. 24 The large bladder capacity and high residual volume could be due to reflux urine going back to the bladder from the dilated system after voiding, but ideally we can only prove this with video urodynamic study and real-time monitoring. 18 In our series, 10 studies were done due to this indication, with abnormalities being detected in all of them, and individualized management plans created; for example, dosage adjustment of anticholinergics, commencement of clean intermittent catheterization and biofeedback, in accordance with other published literature.…”

Section: Discussionmentioning

confidence: 99%

“…Although the latest Swedish reflux infant trial suggested that lower urinary tract dysfunction cannot be prevented by early VUR reflux resolution, they have shown that high postvoid residual at baseline was a predictive factor for both the nonresolution of highgrade VUR reflux and recurrent urinary tract infection. 24 The large bladder capacity and high residual volume could be due to reflux urine going back to the bladder from the dilated system after voiding, but ideally we can only prove this with video urodynamic study and real-time monitoring.…”

Section: Discussionmentioning

confidence: 99%

Wireless ambulatory urodynamic study: A 6‐year retrospective review in a tertiary paediatric urological referral centre

et al. 2018

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Aim: Urodynamic study is a functional assessment of the lower urinary tract. It has an essential role in the evaluation of paediatric patients with lower urinary tract symptoms, be it due to neurogenic or nonneurogenic causes. Since 2013, we have introduced wireless ambulatory form of the study. In the present study, we performed a baseline review of our paediatric urodynamic service within a 6-year period to determine its indications, outcomes and complications. Patients and Methods: A retrospective review of all urodynamic studies performed between August 2011 and April 2017 in patients <18 years of age was performed. Demographics, including age and sex, and indications were collected. Urodynamic parameters, including type of catheter used, presence of detrusor overactivity, bladder compliance, end-fill detrusor pressure, maximum voiding detrusor pressure, postvoid residual bladder volume and bladder emptying efficiency, were collected. Complications from either catheter insertion or the urodynamic study itself were documented. Results: Sixty-seven studies were done between the study period in 55 patients (16 females and 39 males). Fifty-eight ambulatory studies with natural and conventional fill were performed since 2013. The median age at study was 2.1 years (range 0.1-17 years). Indications included myelodysplasia (61 per cent, n = 41 studies), bilateral high-grade vesicoureteric reflux (18 per cent, n = 12), dysfunctional voiding (15 per cent, n = 10) and patient with posterior urethral valve (6 per cent, n = 4). Suprapubic catheters were used in 62 studies in patients with urethral sensation, and transurethral catheters were used in five studies. Overall, 53 studies were considered abnormal (79.1 per cent). No complications resulted from suprapubic catheter insertion or urodynamic studies. Conclusion: Ambulatory urodynamic studies using our unit's protocol remain safe and child friendly, with minimal complications and high patient and parent satisfaction.

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“…LUTD can contribute to recurrent urinary tract infections, vesicoureteral reflux (VUR), and resultant renal scarring. It is considered a negative prognostic indicator of spontaneous resolution of VUR [3]. Additionally, children with LUTD often have parallel bowel dysfunction.…”

Section: Introductionmentioning

confidence: 99%

Complementary and Integrative Management of Pediatric Lower Urinary Tract Dysfunction Implemented within an Interprofessional Clinic

et al. 2019

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Lower urinary tract dysfunction in children is a common multifactorial functional problem that often correlates with bowel dysfunction and behavioral disorders. Ideal management combines integrative therapies that optimize bladder and bowel habits, address behavioral issues, foster mind–body connection, and improve pelvic floor muscle dysfunction. Movement therapies that teach diaphragmatic breathing and relaxation, mind–body awareness, and healthy pelvic floor muscle function are vital for long-term symptom improvement in children. This paper outlines recommendations for integrative management of these patients and discusses a recently developed interprofessional clinic that aims to better meet these patients’ complex needs and to provide patients with an integrated holistic plan of care. Additional work is needed to scientifically assess these treatment models and educate providers across the various disciplines that evaluate and treat these patients.

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The Swedish Infant High-grade Reflux Trial – Bladder function

Cited by 8 publications

References 23 publications

The Swedish infant high-grade reflux trial: Study presentation and vesicoureteral reflux outcome

The Swedish infant high-grade reflux trial: Study presentation and vesicoureteral reflux outcome

Wireless ambulatory urodynamic study: A 6‐year retrospective review in a tertiary paediatric urological referral centre

Complementary and Integrative Management of Pediatric Lower Urinary Tract Dysfunction Implemented within an Interprofessional Clinic

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