PTU - Polskie Towarzystwo Urologiczne
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Urodynamic disorders in children qualified to surgical treatment of vesico-ureteral reflux
Article published in Urologia Polska 2002/55/4.

authors

Tomasz Koszutski, Grażyna Wojtynek, Grzegorz Kudela, Janusz Bohosiewicz
Górnośląskie Centrum Zdrowia Dziecka i Matki, Klinika Chirurgii Dziecięcej Śląskiej Akademii Medycznej w Katowicach Kierownik kliniki: prof, dr hab. Janusz Bohosiewicz

keywords

ureter, vesieo-ureteral reflux, urodynamic examination, detrusor instability

summary

The aim of the study The aim of this study is to estimate functional bladder disorders in children qualified to surgical treatment of primary vesieo-ureteral reflux.
Material and method. Fifty-eight children suffered vesieo-ureteral reflux grade III-V (34 children with unilateral and 24 children with bilateral reflux), in whom surgical treatment was planned, underwent urodynamic examination before operation. In 24 patients dysuria was observed. Urodynamic evaluation contains uroflowmctry, cystometry and pressure - flow - EMG; patients less than 3 years underwent only cystometry.
Results. The results of urodynamic evaluation were normal in 35 patients (60%). In 40% of children functional disorders were seen: detrusor hyperreactivity in 13 patients, hyperreactivity with lowered bladder capacity in 4 patients, hyperreactivity with poor detmsor - sphincter correlation in 2 patients, and detrusor insufficiency in 4 patients. Uni- or bilateral reflux, as well as its grade, did not correlate with normal results of urodynamic examination (p>0.05). The count of normal results was significantly lower in children with micturition disorders (p<0.05). In 19 patients with detrusor hyperreactivity an operation was delayed and pharmacological treatment was introduced. In 6 of them the reflux resolved, and in 13 patients dysuria disappeared and results of urodynamic examination were improved.
Conclusions. Urodynamic examination is helpful for choose an optimal method of treatment of vesieo-ureteral reflux. In children with micturition disorders urodynamic evaluation is necessary before qualification to the surgical treatment.

references

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correspondence

Tomasz Koszutski
Górnośląskie Centrum Zdrowia Dziecka i Matki
ul. Medyków 16
40-752 Katowice
lei: (0-32) 207 1 750. fax: (0-32) 2071S02