Abstract
Objective To discuss the formation of detrusor urinae-externalsphincter dyssynergia and evaluate the outcome of surgical treatment by urodynamic study.Methods Fifty-five children with neurogenic bladder (NB) who underwent pelvic floor strengthening and bladder neck suspension were checked up on urodynamic study before and 4-10 months after operation. The functional variance of bladder and urethra , and relationship between detrusor urinae and sphincter were analyzed statistically.Results Of 34 cases with hyperreflexic detrusor of NB , 30 cases were improved and 4 invalid. The maximal bladder volume increased 89±17.2ml , the maximal urethral pressure decreased 3.1±0.6kPa . Among 21 cases with areflexia or reflex inhibition of NB, the reflex of detrusor urinae in 11 was improved obviously , and 10 was better. The maximal bladder volume increased 55.6±10.3ml ,the maximal urethral pressure decreased 2.9±0.7kPa.Conclusions The pelvic floor strengthening and bladder suspension are effective procedures in the treatment for NB in children. It is suggested that the detrusor external- sphincter dyssynergia is a compensatory contraction of the external sphincter to the funnel-like bladder neck from paralysis of pelvic floor in lumbosacral myelomeningocele.
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