1628 NEAR INFRARED SPECTROSCOPY (NIRS) AND ALTERED DETRUSOR OXYGEN CONSUMPTION IN NON-NEUROGENIC LOWER URINARY TRACT DYSFUNCTION IN CHILDREN

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Urodynamic Testing1 Apr 20101628 NEAR INFRARED SPECTROSCOPY (NIRS) AND ALTERED DETRUSOR OXYGEN CONSUMPTION IN NON-NEUROGENIC LOWER URINARY TRACT DYSFUNCTION IN CHILDREN Koroush Afshar, Babak Shadgan, Lynn Stothers, and Andrew Macnab Koroush AfsharKoroush Afshar More articles by this author , Babak ShadganBabak Shadgan More articles by this author , Lynn StothersLynn Stothers More articles by this author , and Andrew MacnabAndrew Macnab More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1408AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Non-neurogenic lower urinary tract dysfunction (NLUTD) is a common problem of childhood affecting 15-30% of populations surveyed. Although abnormal urodynamic features have been indentified including abnormal filling and emptying parameters such as abnormal flow patterns and increased post void residual urine, possible underlying causes for the condition remain largely unexplained. Near infra-red spectroscopy (NIRS) adds new non-invasive parameters for evaluation of detrusor function by monitoring alterations in detrusor oxygenation and hemodynamics during urodynamics via changes in chromophore concentrations [oxygenated (O2Hb), deoxygenated (HHb) and total (tHb)]. The purpose of this study is to compare changes in NIRS parameters during voiding in asymptomatic controls to children with NLUTD. METHODS 20 symptomatic children (3-14 yrs) with NLUTD and 5 asymptomatic children (controls age 5–14 yrs) participated in this prospective cohort series. Subjects were studied at a tertiary care children's hospital after natural bladder filling. NIRS changes in O2Hb and HHb were monitored transcutaneously at 10 Hz during uroflow using wireless NIRS over the detrusor. Patterns of change in chromophore concentration from permission to void (zeroed to baseline) through to uroflow end were compared. RESULTS Patterns of chromophore change in asymptomatic subjects had good intersubject reproducibility (increased tHb [02Hb+HHb] following permission and upward trend of tHb during uroflow, predominantly due to elevated O2Hb). In children with NLUTD a different pattern was observed with tHb increase blunted or absent and HHb concentration greater than O2Hb; a pattern consistent with altered detrusor hemodynamics and oxygenation associated with muscular fatigue. A representative comparison is shown below. CONCLUSIONS NIRS monitoring in NLUTD demonstrates chromophore changes of altered detrusor hemodynamics/oxygenation which differs from those seen in asymptomatic controls. Changes in the detrusor oxygenation were consistent with oxygen consumption and muscular fatigue providing a possible underlying mechanism for urgency, frequency and incontinence seen in dysfunctional voiders using a non invasive technology. Vancouver, Canada© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e629 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Koroush Afshar More articles by this author Babak Shadgan More articles by this author Lynn Stothers More articles by this author Andrew Macnab More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...