Int Neurourol J.  2022 Mar;26(1):52-59. 10.5213/inj.2142244.122.

A Study of Urodynamic Parameters at Different Bladder Filling Stages for Predicting Upper Urinary Tract Dilatation

• Lyu L
• Yao YX
• Liu EP
• Zhang YP
• Hu HJ
• Ji FP
• Pu QS
• Yang XH
• Wang QW
• Wang Y
• Wen JG

• KMID: 2528267
• DOI: http://doi.org/10.5213/inj.2142244.122

Abstract

Purpose
To identify more accurate predictors of upper urinary tract dilatation (UUTD) in neurogenic bladder (NB) children, we studied the relationship among urodynamic parameters at different bladder filling stages, detrusor leak point pressure (DLPP) and UUTD.
Methods
A total of 158 children (3–16 years) with NB were included and then divided into 2 groups according to whether their NB diagnosis was complicated with UUTD: the UUTD group (39 patients) and those without UUTD group (control group, 119 patients). The bladder filling phase was divided into 3 equal parts: the early, middle, and end filling stages. The bladder compliance (BC) and detrusor pressure (△P_det) at each phase and DLPP at the end filling stage were recorded.
Results
A BC<8 mL/cm H₂O both in the middle and end stages is more specific than a BC<9 mL/cm H₂O in the end stage (72%, 73%, vs. 66%), and △P_det >8 cm H₂O in the early stage, 20 cm H₂O in the middle stage and 25 cm H₂O in the end stage are more sensitive than △P_det >40 cm H₂O in the end stage (82%, 85%, 85%, vs. 49%). A DLPP cutoff value of 20 cm H₂O showed higher sensitivity for predicting UUTD than 40 cm H₂O.
Conclusions
Low BC and a high △P_det in the middle and end filling stages are more accurate factors than classic indicators for predicting UUTD. In addition, a DLPP value of >20 cm H₂O in the end bladder filling stage shows high sensitivity.

Keyword

ladder compliance; Detrusor pressure; Detrusor leak point pressure; Child; Upper urinary tract dilatation