Unstable Bladder in Children: Functional Evaluation by Modified Voiding Cystourethrography

Fötter, R.; Köpp, Werner; Klein, Elizabeth; Höllwarth, Michael E.; Uray, E

doi:10.1016/s0022-5347(17)44535-6

Cited by 4 publications

(7 citation statements)

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“…urethral ballooning. In 1986, Fotter et al [ 6] described a modified video‐cystography with simultaneous monitoring of bladder pressure, in which they were able to assess the opening of the bladder neck during involuntary detrusor contractions. Opening of the bladder neck during cystography had a sensitivity of 93% in predicting DI in children referred for enuresis or recurrent UTI.…”

Section: Discussionmentioning

confidence: 99%

“…DI has been detected in children with enuresis with daytime symptoms, recurrent UTIs and VUR with varying incidences [ 2–5]. Some of these children undergo radiological studies before urodynamics and several authors have described the radiological signs associated with DI [ 3, 6–8] either during modified voiding cysto‐urethrography (VCUG) (with an indirect measurement of bladder pressure) or during video‐urodynamic studies (VUD). As VUD are not available in many hospitals, the diagnostic yield of serial films of a conventional VCUG needs to be defined.…”

Section: Introductionmentioning

confidence: 99%

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The reliability of cysto‐urethrographic signs in the diagnosis of detrusor instability in children

Batista

Caffaratti

AraÑÓ

et al. 1998

British Journal of Urology

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Objective To assess whether the signs associated with specific signs (only vesico-ureteric reflux or vaginal voiding) in 25 (49%) of patients, whereas 26 (51%) detrusor instability (DI), as assessed by videourodynamic studies, can be evaluated by conventional had some signs suspicious of DI. Suspicious signs were urethral ballooning (in 11), bladder trabeculation or voiding cysto-urethrography (VCUG). Patients and methods Fifty-nine children who under-a constricting ring (eight), a 'spinning-top' urethra (three), urethral notching (two) and Mercier's bar went cystometry and VCUG were reviewed and divided into two groups; group 1 comprised 51 neurologically (one). In group 2, five patients had no abnormal findings on VCUG and three had suspicious signs. The normal children who had DI (47 girls and four boys, mean age 7.9 years, range 4-14), with no malfor-positive predictive value of VCUG was high (0.89) but the diagnostic yield of suspicious signs was low, mations or previous surgery. Most had mixed symptoms, including urinary tract infections (44) and because the sensitivity (0.5), specificity (0.62) and overall accuracy (0.52) were low. nocturnal enuresis with daytime symptoms (20); group 2 (control) comprised eight children (seven girls, Conclusion Radiological signs suspicious of DI cannot be regarded as such in conventional VCUG, as mean age 9.7 years, range 6-15) with a stable bladder and the same clinical presentation. The interval although they were detected in half the patients with DI, they also occurred in three of eight children with between VCUG and cystometry ranged from 1 day to 5 months (mean 47 days) and was similar in both a stable bladder. Keywords Bladder instability, children, voiding cysto-groups. Signs considered suspicious of DI were sought in the findings of VCUG.urethrography Results In group 1, VCUG was normal or showed no

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The reliability of cysto‐urethrographic signs in the diagnosis of detrusor instability in children

Batista

Caffaratti

AraÑÓ

et al. 1998

British Journal of Urology

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“…Urethral sonography was performed with a range of high-resolution linear and curved linear multifrequency transducers (8)(9)(10)(11)(12)(13)(14)(15) and an Acuson Sequoia 512 scanner (Siemens Medical Solutions, Mountain View, CA). After a conventional thorough evaluation of the entire UT in physiologic hydration, the transducer was placed on the perineum at its midline between the patient's anus and scrotum or labia for additional perineal evaluation of the urethra ( Figure 2).…”

Section: Methodsmentioning

confidence: 99%

“…In all patients, the VCUG technique included cyclic filling and a modified protocol using the drop speed of the contrast agent infusion at the physiologic filling pressure to guide fluoroscopy. 11 Urethral anatomic structures were assessed from images taken at the fluoroscopic evaluation of voiding with the last image hold technique and lateral spot films. The urethral catheter was removed before voiding after the last filling.…”

Section: Methodsmentioning

confidence: 99%

Sonographic Diagnosis of Urethral Anomalies in Infants

Schoellnast

Lindbichler

Riccabona

2004

J of Ultrasound Medicine

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“…Intermittent fluoroscopy during bladder filling is essential to improve detection of transient reflux. Flow rate of the drip infusion of contrast material should be watched continuously and fluoroscopy performed whenever the drip stops or is markedly reduced, as this signals an increased bladder pressure caused either by the beginning of micturition or by bladder instability (38,66).…”

Section: Voiding Cystourethrography (Vcu)mentioning

confidence: 99%

Diagnosis of vesico‐ureteric reflux

Hellström

Jacobsson

1999

Acta Paediatrica

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The demonstration and grading of reflux is crucial in examination and follow‐up of any child with upper urinary tract infection. A variety of factors can influence the occurrence of reflux, e.g. race, genetics, state of maturation of the ureterovesical valve, diuresis, infection and bladder dysfunction, including obstruction and neurogenic disorders. Even when reflux is investigated under strictly standardized conditions, two consecutive bladder fillings frequently show different grades of reflux. Voiding cystourethrography is, to date, the only method with a generally accepted, well‐defined grading of reflux. It also allows detection of intrarenal reflux and anatomical and functional information about the bladder and urethra that is unobtainable by other methods. It is therefore usually considered the method of choice. Radionuclide cystography and, possibly, contrast enhanced ultrasonography can be complementary to voiding cystourethrography, but mainly for postoperative follow‐up and screening of siblings.

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Unstable Bladder in Children: Functional Evaluation by Modified Voiding Cystourethrography

Cited by 4 publications

References 0 publications

The reliability of cysto‐urethrographic signs in the diagnosis of detrusor instability in children

The reliability of cysto‐urethrographic signs in the diagnosis of detrusor instability in children

Sonographic Diagnosis of Urethral Anomalies in Infants

Diagnosis of vesico‐ureteric reflux

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