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ICCS S4-4
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CAN NON-INVASIVE URODYNAMICS REPLACE VIDEO-URODYNAMICS IN BOYS
WITH PUV?
Aurora MARIANI
1
, Joanna CLOTHIER
2
, Kalpana PATIL
1
, Arash TAGHIZADEH
1
, Massimo GARRIBOLI
1
and Anne WRIGHT
3
1) Evelina London Children's Hospital - Guy's and St Thomas NHS Foundation Trust, Paediatric Urology, London, UNITED
KINGDOM - 2) Evelina London Children's Hospital - Guy's and St Thomas NHS Foundation Trust, Paediatric Nephrology
and Children's Bladder clinic, London, UNITED KINGDOM - 3) Evelina London Children's Hospital - Guy's and St Thomas
NHS Foundation Trust, Paediatric and Children's Bladder clinic, London, UNITED KINGDOM
PURPOSE
Non-invasive urodynamics (NIU) is used as a first line test to assess bladder function prior to Videourodynamics (VUD)
in boys with posterior urethral valve (PUV). Aim of the study was to compare NIU and VUD performed at 5 years of age
to determine whether an invasive assessment is necessary at this time-point.
MATERIAL AND METHODS
We retrospectively reviewed the results of NIU and VUD performed at about 5 years of age in boys with PUV born
between 2005 and 2009. Bladder capacity (BC), post void residual (PVR), detrusor over activity (DOA) and bladder
compliance were compared. Patients with PVR less than 10% of BC at NIU were considered normal.
RESULTS
Seventy-one patients were identified. Thirty-five boys had both NIU and VUD and were included in the analysis. Median
age at NIU and VUD was 58 months (range 38-71) and 61 months (range 44-92), respectively (p=0.06). Mean BC at
NIU was 204.8 ml (range 87-356) and at VUD was 223.8 ml (range 59-520) Pearson r=0.459 (p=0.006). Mean PVR at
NIU was 56.48 ml (range 0-319) and at VUD was 45.77 ml (range 0-350) Pearson r=0.517 (p=0.03). Fourteen patients
(36%); had a PVR less than 10% at NIU: in these boys VUD showed DOA greater than 15 cmH2O in 8/14 (58%),
median 42.5 cmH2O (15-88); vesico-ureteric reflux was identified in 3/14 (22%) and median bladder compliance was
11.5 ml/cmH2O (range 1-76).
CONCLUSIONS
There is good concordance of NIU and VUD for BC and PVR, but by themselves NIU may miss important data such as
presence of DOA, VUR and diminished compliance.