492 ARE WE UNDERESTIMATING BLADDER CAPACITY IN CHILDREN LESS THAN ONE YEAR OF AGE?

Abstract

You have accessJournal of UrologyPediatrics: Neuropathic Bladder/Reconstruction1 Apr 2013492 ARE WE UNDERESTIMATING BLADDER CAPACITY IN CHILDREN LESS THAN ONE YEAR OF AGE? Daniel F.G. Costa, Luke T. Lavallée, Michael Leonard, and Luis Guerra Daniel F.G. CostaDaniel F.G. Costa Ottawa, Canada More articles by this author , Luke T. LavalléeLuke T. Lavallée Ottawa, Canada More articles by this author , Michael LeonardMichael Leonard Ottawa, Canada More articles by this author , and Luis GuerraLuis Guerra Ottawa, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1884AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Estimating bladder capacity is an important component in the evaluation of many urological disorders. For estimates to be of clinical value, precise reference ranges are needed. While accepted reference ranges have been established in adults and older children, none have been validated in infants. Kaefer et al proposed the formula [2* age (years) + 2] for children less than 2 years of age which gives an estimation of bladder capacity in ounces. This implies an average bladder capacity of 60 to 120ml for children from birth to 12 months of age. Our anecdotal experience suggests this range is frequently an over-estimate. We endeavor to determine the normal bladder capacity of children less than 1 year of age. METHODS We retrospectively reviewed the charts of children aged 0-12 months with cutaneous stigmata of spinal dysraphism who were referred to the urology clinic at the Children's Hospital of Eastern Ontario to rule out occult spina bifida between October 2004 and July 2011. Patients with normal urologic assessment, defined as those not undergoing surgery for release of tethered cord, normal ultrasound of the abdomen and pelvis, and normal urodynamic testing, were included in the study cohort. Urodynamic studies were performed by a dedicated urodynamics nurse using the Laborie Medical Technologies UDS-600. Bladder filling occurred via a catheter at a rate of 10% of the expected total bladder capacity/min Bladder capacity was defined as the volume of filling when the child voided around the catheter. We analyzed age at urodynamics, bladder capacity, detrusor pressure at capacity, bladder compliance and length of follow up. RESULTS Forty-six percent (84/183) of patients had a normal urologic assessments and met the study inclusion criteria. The average age of our patients was 8.2 months (SD = 3.1). The average bladder capacity was 46.8 ml (SD = 30.6) and the mean detrusor pressure at capacity was 9.0 cmH2O (SD = 11.1). Mean compliance was calculated to be 14.0 ml/cmH2O (SD = 13.8). The average length of follow up for our study was 41.5 months (SD = 26.9) and during this interval no patients underwent surgery for tethered cord release CONCLUSIONS Bladder capacity in infants with a mean age of 8.2 months was found to be 46.8 ml. This is less than half of the volume predicted by a commonly employed formula. A novel method of estimating bladder capacity in infants is required. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e202 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Daniel F.G. Costa Ottawa, Canada More articles by this author Luke T. Lavallée Ottawa, Canada More articles by this author Michael Leonard Ottawa, Canada More articles by this author Luis Guerra Ottawa, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...