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14.12.2017 | Urology - Original Paper

Impact of posterior urethral diameter/external urethral sphincter diameter as a new tool to predict detrusor pressure in the voiding phase

verfasst von: Masafumi Kon, Takahiko Mitsui, Takeya Kitta, Kimihiko Moriya, Nobuo Shinohara, Masayuki Takeda, Katsuya Nonomura

Erschienen in: International Urology and Nephrology | Ausgabe 2/2018

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Abstract

Purposes

We measured posterior urethra diameter (PUD) and external urethral sphincter diameter (EUSD), which can also be measured by voiding cystourethrography (VCUG) and investigated the relationship between PUD/EUSD and detrusor pressure (Pdet) during voiding by videourodynamics (VUDS).

Methods

Sixty-three children, who were 3 years old or less and underwent VUDS, were enrolled in the present study. We measured PUD and EUSD in addition to detrusor pressure at the time of the widest EUS during voiding (Pdet-voiding) by VUDS, and PUD/EUSD was investigated compared to Pdet-voiding.

Results

Seventy-eight VUDS were performed in 63 patients, and the median age at VUDS was 10.2 months. These studies revealed a significant correlation between PUD/EUSD and Pdet-voiding (r = 0.641, p < 0.001). However, a significant correlation was not observed between PUD/EUSD and age (r = 0.180). We defined Pdet-voiding of more than 80 cmH₂O as a high voiding pressure, and a PUD/EUSD of 2.4 was a good predictor for the cutoff value for high voiding pressure. Pdet-voiding was significantly higher in children with a PUD/EUSD of ≥ 2.4 (p < 0.001). In 19 children who had neurological diseases, a significant correlation was found between PUD/EUSD and Pdet-voiding (r = 0.842, p < 0.001), and a PUD/EUSD of 2.4 was a useful cutoff value for high voiding pressure.

Conclusions

PUD/EUSD is a valuable tool to predict high voiding pressure in pediatric patients. A PUD/EUSD of ≥ 2.4 in VCUG indicates the need to perform more invasive tests, such as VUDS, in pediatric patients aged 3 and under with neuropathic diseases.

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Titel: Impact of posterior urethral diameter/external urethral sphincter diameter as a new tool to predict detrusor pressure in the voiding phase
verfasst von: Masafumi Kon
Takahiko Mitsui
Takeya Kitta
Kimihiko Moriya
Nobuo Shinohara
Masayuki Takeda
Katsuya Nonomura
Publikationsdatum: 14.12.2017
Verlag: Springer Netherlands
Erschienen in: International Urology and Nephrology / Ausgabe 2/2018
Print ISSN: 0301-1623
Elektronische ISSN: 1573-2584
DOI: https://doi.org/10.1007/s11255-017-1770-0

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Abstract

Purposes

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Results

Conclusions

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