The influence of bladder compliance on children with neurogenic underactive bladder treated with clean intermittent self-catheterization
ZHANG Rui-li, HU Jin-hua, WANG Qing-wei, LOU An-feng, ZHANG Guo-xian, XING Lu, WANG Yan, WEN Jian-wen
Published 2009-11-15
Cite as Chin J Pediatr Surg, 2009,30(11): 767-770. DOI: 10.3760/cma.j.issn.0253-3006.2009.11.008
Abstract
Objective To investigate the influence of bladder compliance on complications and bladder development on children with neurogenic underactive bladder (NUB) treated with clean intermittent self-catheterisation (CISC). Methods In this study, 109 school children with NUB were enrolled. Of all the patients,93(85%) were successfully followed up for two years after CISC. According to bladder compliance,93 patients were further subdivided into two groups, normal bladder compliance group (49 patients including 30 boys and 19 girls with the mean age of 6. 3± 0.9 years,as the NBC group) and poor bladder compliance group (44 patients including 29 boys and 15 girls with the mean age of 7. 0± 1.0 years,as the PBC group). Urodynamic parameters and complications were compared between two groups. Results After CISC for two years, the maximal cystometric capacity (MCC) and relative safe cystometric capacity (RSCC) in the NBC group were respectively significantly higher than those before CISC. However, the RSCC in the PBC group was significantly lower than that before CISC,and detrusor leakage point pressure (DLPP) was significantly higher than that before CISC (P <0. 05). Moreover, the bladder compliance, MCC and RSCC in the PBC group were respectively significantly lower than those in the NBC group after CISC,and DLPP was significantly higher than that in the NBC group (P<0. 05). The incidence of baeteriuria,vesico ureteral reflux (VUR), febrile urinary tract infections (FUTI) and macroscopic hematuria were respectively 33. 3%, 12. 9%,24. 7% and 15. 1%. VUR and FUTI in the PBC group were significantly higher than those in the NBC group (P< 0. 05). Conclusions It is suggested that bladder compliance may influence the bladder development and complications in children with NUB treated with CISC. Close monitoring and follow-up are necessary for the patients with poor bladder compliance and progressive deteriorated bladder development.
Key words:
Bladder neurogenic; Urodynamics; Bladder compliance
Contributor Information
ZHANG Rui-li
Department of Urod ynamic Center and Urology, 1st Affiliated Hospital Of Zhengzhou University, Institute of Clinical Medical Research of Henan Universities, Zhengzhou, 450052, China
HU Jin-hua
Department of Urod ynamic Center and Urology, 1st Affiliated Hospital Of Zhengzhou University, Institute of Clinical Medical Research of Henan Universities, Zhengzhou, 450052, China
WANG Qing-wei
Department of Urod ynamic Center and Urology, 1st Affiliated Hospital Of Zhengzhou University, Institute of Clinical Medical Research of Henan Universities, Zhengzhou, 450052, China
LOU An-feng
Department of Urod ynamic Center and Urology, 1st Affiliated Hospital Of Zhengzhou University, Institute of Clinical Medical Research of Henan Universities, Zhengzhou, 450052, China
ZHANG Guo-xian
Department of Urod ynamic Center and Urology, 1st Affiliated Hospital Of Zhengzhou University, Institute of Clinical Medical Research of Henan Universities, Zhengzhou, 450052, China
XING Lu
Department of Urod ynamic Center and Urology, 1st Affiliated Hospital Of Zhengzhou University, Institute of Clinical Medical Research of Henan Universities, Zhengzhou, 450052, China
WANG Yan
Department of Urod ynamic Center and Urology, 1st Affiliated Hospital Of Zhengzhou University, Institute of Clinical Medical Research of Henan Universities, Zhengzhou, 450052, China
WEN Jian-wen
Department of Urod ynamic Center and Urology, 1st Affiliated Hospital Of Zhengzhou University, Institute of Clinical Medical Research of Henan Universities, Zhengzhou, 450052, China