The Value of Urodynamic Study in Neurologically and Anatomically Normal Children with Micturition Dysfunction

Woo, Ho Cheol; Choi, Seong Kang

Abstract

Normal micturition is usually accomplished by 3 years of age. We have experienced micturition dysfunction in neurologically and anatomically normal children, but we are embarrassed in identifying the exact cause of each case and searching for the treatment modalities. I thought there was a possibility of lower urinary tract dysfunction as an evoking factor of micturition dysfunction and so I conducted urodynamic study in neurologically and anatomically normal children with micturition dysfunction at Yonsei University Hospital from April, 1984 till December, 1986 and have come to the conclusion as follows ; 1. There was normal urodynamic findings in 9 cases(26.5%) and single abnormal findings in 18 cases(52.9%) which were composed of 6 cases(17.6%) of unstable bladder findings, 2 cases(5.9%) of hypersensitive bladder, 9 cases(26.5%) of high maximum urethral closure pressure and 1 case(2.9%) of detrusor-sphincter dyssynergia and combined abnormal findings in 7 cases(20.6%). High maximum urethral closure pressure finding, which was main abnormal one were found in 13 cases(38.2%), while unstable bladder in 12 cases(35.3%) among 34 children with micturition dysfunction. 2. Among the urodynamic parameters under anesthetic or awaken state, only the mean value of percentage of bladder capacity to normal was significantly higher in anesthetic group than awaken group. 3. Among the urodynamic parameters according to single symptom, all(percentage of bladder capacity to normal, maximum urethral closure pressure) were lower in incontinent group and maximum urethral closure pressure was higher in frequency group, but these differences were not statistically significant. 4. The satisfactory result of conservative treatment was found in 25 cases(73.5%), and was better in the group with single abnormal finding than with combined abnormal finding. In conclusion, the urodynamic study is essential to get the diagnosis and give the treatment accurately, but there should be more technical improvement doing in pediatric age group.