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

Abstract

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.