Are Urodynamic Studies Really Necessary in Voiding Dysfunction in Children?

Abstract

Aim:Urodynamic examination is considered the most reliable, but also a quite invasive tool for the diagnosis of voiding dysfunctions in children. In this study, we evaluated the role of invasive urodynamics in the diagnosis of lower urinary tract dysfunction in children.Methods:One thousand one hundred twenty seven patients underwent urodynamic studies in the pediatric nephrology clinic in Ege University Faculty of Medicine between March 2011 and March 2016. A retrospective analysis of data including symptoms of voiding dysfunction (urinary frequency, urgency, nocturia and/or urge incontinence) and findings of physical examination, urodynamics and ultrasonography was performed.Results:Two hundred and seventy-seven (30.8%) boys and 620 (69.1%) girls with a mean age of 7.52 (±2.6) years underwent urodynamic studies. The most common abnormality was overactive bladder detected in 630 patients (70.2%). 19.9% (n=179) of the participants had dysfunctional voiding, while 9.8% (n=88) had normal results.Conclusion:A small and frequent voiding pattern, enuresis nocturna with daytime symptoms, and postvoid urinary residual volume were the common findings seen in patients with overactive bladder. In addition, dyssynergic voiding and a bladder with large capacity but residual volume after voiding were also commonly found. To that end, we may use ultrasound, clinical examination, symptoms and voiding frequency as first-line diagnostic tools.

Keywords

• Children
• voiding dysfunction
• detrusor instability
• dyssynergic voiding
• urodynamic studies