Ureteric Jet Doppler Waveform and Bladder Wall Thickness in Children With Nocturnal Enuresis

Abstract

In this article, the authors propose a non-invasive method to evaluate children with enuresis by correlating findings of color Doppler ultrasound of ureteric jet and bladder wall thickness. The authors compared the ultrasound findings in a group ABSTRACT:To test the hypothesis that the presence of nocturnal enuresis is related to increased frequency of immature vesicoureteric function, which is further associated with detrusor overactivity, we compared the incidence of immature monophasic ureteric jet in children with and without nocturnal enuresis. The relationship between monophasic ureteric jet Doppler wave form and bladder wall thickness was further explored in the enuresis group. Ultrasound examinations were performed in 511 children suffering from nocturnal enuresis and 266 normal controls. Doppler wave forms of the ureteric jet on each side and the bladder wall thickness after voiding were recorded. Standard urodynamic studies were obtained in 203 enuretic children for correlations with ultrasound findings. There was a significant increase in the incidence of monophasic ureteric jet waveforms in enuretic children when compared with the controls (19.2% versus 6.4% on the right side, 19.2% versus 8.3% on the left side, all p Ͻ 0.01). Furthermore, immature monophasic waveforms were more commonly seen in the enuretic group with markedly thickened bladder wall. Enuretic children with bilateral immature ureteric jet waveforms and markedly thickened bladder wall showed multiple significant urodynamic abnormalities (p Ͻ 0.05). The above observations could be accounted for by immaturity of both vesicoureteric junction and detrusor muscle.

Doppler waveforms of the ureteric jet: an overview and implications for the presence of a functional sphincter at the vesicoureteric junction

“…The incidence of immature monophasic jet was significantly greater in enuretic children (19.2% in both sides) than in normal children (6.4% on the right side and 8.3% on the left side). Furthermore, the immature waveform was more commonly seen in the enuretic group with a markedly thickened bladder wall and multiple urodynamic abnormalities [5]. …”

“…However, the association of the monophasic jet waveform with VUR and UTI might partially explain why pregnant women with a higher incidence of the monophasic jet pattern are also more prone to VUR and UTI [4]. A higher incidence of the immature jet pattern is also found in children with nocturnal enuresis [5]. This suggests that there is a lower level of maturity of the VUJ in a proportion of enuretic children.…”

“…The characteristics of ureteric jets in a normal population of 1,341 subjects are described and the effect of age, gender and bladder-filling (based on a subgroup of 102 normal adult females) are discussed. A summary of jet patterns seen in children with urinary tract infection/vesicoureteric reflux (VUR) ( n  = 98) [4] and nocturnal enuresis ( n  = 511) [5] is also presented. Special groups, including pregnant women ( n  = 107) [6], anaesthetized children ( n  = 16) [7] and subjects with ureteric transplantation ( n  = 55) [8] are also discussed to look at changes of ureteric jet patterns under specific physiological conditions.…”

Dynamic Ultrasound Study on Urinary Bladder in Infants With Antenatally Detected Fetal Hydronephrosis

“…Therefore, we postulated that dilated RP might associate with bladder dysfunction, which could be reflected by abnormal bladder parameters such as MaxBV, RV, and BWT quantitatively. Our previous study on enuretic children has showed that there were significant correlations between abnormal thickness of the bladder wall and multiple abnormal parameters demonstrated by urodynamic studies (10).…”

Formato da onda do jato ureteral ao estudo Doppler espectral: comparação interobservadores. Estudo prospectivo em crianças assintomáticas

“…2010;43(1): 35-38. ner. The alterations in the function of the lower urinary tract may be divided into neurological (neurogenic bladder), most frequently resulting from spinal dysraphism and cerebral palsy; and functional, caused by disorders in children with no evidence of neurological diseases (1,2) . The relevance of early diagnosis is related to the possibility of establishing the treatment in order to…”