Ces Urol 1999, 3(3):13-20

Urodynamic findings in infants undergoing surgery for lower urinary tract dysfunction

Ivo Novák, Hvězdoslav Stefan

Urologická klinika, FN Hradec Králové

Authors summarize the urodynamic examination results of 14 reconstructive surgeries in infants with lower urinary tract dysfunction (9 girls and 5 boys with cysto-plasty in age 3,5 -15 years). The follow-up period reached from 6 months to 7,5 years. The urinary bladder capacity was increased to 130 - 565 ml by the surgery in all patients. Any correlation to the provided type of enterocystoplasty was not found. The values of reservoir compliance were between 7,8 - 54,5 ml/cm FEO. The profilometry has found the functional length of profile from 10 to 75 mm (in boys 23 - 75 mm, in girls 10-50 mm) in patients with neck plasty according to Young-Dees-Leadbetter, from 36 - 69 mm in modified Kropp plasty (girls only) and 51 mm in neck plication. The maximum closing urethral pressure in Young-Dees-Leadbetter's plasty was 27 - 130 cm FEO (47 -130 cm FEO in boys, 36 - 73 cm FEO in girls), in modified Kropp plasty 23 - 55 cm FEO and in neck plication 17 cm FEO. In the group of patients with appendicovesicostomy has the efflux pressure reached 40-191 cm FEO with the functional length of 36 to 83 mm. The surgical outcome was appreciated for increasing the quality of life by 13 patients or their parents. The daily and nocturnal incontinence remained unchanged only in one patient. The intermittent nocturnal incontinence continues in one girl. One boy urinates without necessity of being catheterized. All other patients have to be catheterized. These favourable clinical findings were confirmed by urodynamic examinations.

Keywords: Urodynamic examination in infants, Lower urinary tract dysfunction, Urinary bladder augmentation, Bladder neck plasty, Appendicovesicostomy

Published: June 1, 1999