Studies of Intravesical Pressure and Uroflow Rate in Children with Bladder Outflow Obstraction

Abstract

Objective:To introduce a method to diagnose bladder outflow obstruction(BOO)in children.Methods:Thirty-one children with the lower urinary tract dysfunction were tested by pressure-flow-EMG studies.A catheter for measuring intravesical pressure was inserted into the bladder through the suprapubic vesical puncture.The uroflow rate,intravesical pressure,rectal pressure and EMG were measured.BOO was diagnosed referring to Abrams and Griffiths diagram and p-Q plot,and divided into 7 degrees according to the linear passive urethral resistance relation (PURR)and Schiller diagram.The detrusor-external sphincter dysynergia(DESD)was divided into 3 types:initial(Ⅰ),intermittent(Ⅱ)and continuous(Ⅲ).Results;The incidence of Ⅱ,Ⅲ,Ⅳ,Ⅴ or Ⅵ degree of BOO was 9.1%,22.7%,13.6%,40.9%and 13.6%respectively in 22 children with organic BOO.The incidence of Ⅰ,Ⅱ,Ⅲ type DESD was 11.1%,55.6% and 33.3% respectively in 9 children with functional BOO.After operation,BOO improved in 4 of the 5 children with urethral valve.Conclusions:This method can make an accurate diagnosis and grades of BOO and is important to evaluate the efficacy. Key words: Bladder neck obstruction; Urodynamics; Urethral diseases