Can Urodynamic Findings of Overactive Bladder Determine the Treatment Effect of Urotherapy in Children?

Abstract

To assess the correlation between urodynamic study findings and urotherapy treatment response in children with urotherapy-resistant overactive bladder (OAB). A cross-sectional study. Department of Pediatric Urology, Children's Hospital of Chongqing Medical University, Chongqing, China, from January 2016 to March 2018. The study included 232 children presented with urotherapy-resistant OAB defined as (completing threemonth standard urotherapy with sustained OAB symptoms. After excluding urinary infection and neurogenic, anatomical abnormalities, urodynamic study (UDS) was proceeded to record DO (detrusor overactivity) and maximum CBC (cystometry bladder capacity), pelvic floor awareness was guided during UDS. Following UDS, standard urotherapy and pelvic floor training was continued for another month and treatment effect was evaluated. At the end of one-month; of urotherapy following UDS, significant response (SR) was observed in 57.3% (133/232) children. As 28.9% (67/232) children showed partial response (PR), the other 13.8% (32/232) children showed no response (NR). The results showed that patients with normal bladder function or DO respond equally well to urotherapy. The percentage of significant response (SR) was 68.9% (93/135) and 60.0% (27/45) (p=0.148), which was significantly better than children with decreased CBC (DCBC) (SR: 33.3%, 10/30) or DO+DCBC (SR: 13.6%, 3/22, p=0.000). Urodynamic verification of DO is not a prerequisite for urotherapy treatment response. Decreased cystometry bladder capacity (DCBC) found in UDS may suggest a poorer treatment response to urotherapy than patients with normal CBC.