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ICCS S5-3
(SO)
URODYNAMIC DIFFERENCES BETWEEN HIGH PRESSURE VERSUS LOW PRESSURE
DETRUSOR OVERACTIVITY IN PATIENTS WITH SPINA BIFIDA
S. Kerem OZEL
1
, Ibrahim ALATAS
2
, Tuba TUNC
3
, Altan ALIM
1
and Huseyin CANAZ
2
1) Istanbul Bilim University Spina Bifida Research Center, Paediatric Urology, Istanbul, TURKEY - 2) Istanbul Bilim
University Spina Bifida Research Center, Paediatric Neurosurgery, Istanbul, TURKEY - 3) Darica State Hospital,
Neonatology, Izmit, TURKEY
PURPOSE
The aim of the study is to delineate the differences between high pressure and low pressure detrusor overactivity in
patients with spina bifida.
MATERIAL AND METHODS
Patients for whom urodynamic study was done with the diagnosis of spina bifida were studied. No patients had
anticholinergic treatment during the studies. Age of the patients, gender, bladder capacity, leak point pressures (LPP),
postvoiding residual urine and compliance were questioned. Patients were divided into two groups; Group 1, patients
with detrusor overactivity with LPP over 60 cmH2O and Group 2, pressures below 60 cmH2O. Numeric values were
analysed with independent samples t test and nominal values with chi-square test.
RESULTS
A total of 519 urodynamic studies were evaluated. For 275 patients, urodynamic study was done for spina bifida. Only
patients who had detrusor overactivity were selected. There were 61 patients in Group 1 and 17 patients in Group 2.
Mean age of the patients in Group 1 was 6.65±6.24 months vs. 6.52±3.55 months in Group 2. Gender difference was
insignificant. Bladder capacities in Group 1 was 31±16.4 ml vs. 41.4±25 ml in Group2 (p=0,046). LPP in Group 1 was
118.3±35 cmH2O vs. 48.2±12.3 cmH2O in Group 2 (p=0,002).Mean residual urine was 9±12.3 ml in Group 1 whereas
19.5±25.1 ml in Group 2 (p=0,016). Bladder compliance was more reduced in Group 2 (p=0,0001).
CONCLUSIONS
Bladder capacities of those patients with high LPP are more reduced due to increased contractility. They also have less
residual urine secondary to high pressures. Increased frequency of low compliance in low pressure patients may be due
to decreased detrusor contractility as a sign of a more severe condition. Delineation of these urodynamic differences
may help for a better understanding of neuropathic bladder dysfunction in patients with spina bifida.