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15:36 - 15:42
ICCS S6-2
(LO)
NON INVASIVE EVALUATION OF CHILDREN WITH BOWEL BLADDER
DYSFUNCTION
Giuseppe MASNATA
1
, Valeria MANCA
1
, Laura CHIA
1
, Francesca ESU
1
, Giuseppe LEDDA
1
, Chiara GUZZETTI
1
, Fabrice
DANJOU
2
and Pierpaolo PUSCEDDU
3
1) Azienda Ospedale G. Brotzu, Pediatric Urodynamic and Urology, Cagliari, ITALY - 2) CNR - Cagliari, Institute of
neurogenetics and neuropharmacology, Monserrato, ITALY - 3) Azienda Ospedale G. Brotzu, Pediatric Department,
Cagliari, ITALY
PURPOSE
Children with Lower Urinary Tract Symptoms (LUTS) are widely represented in a school age population (15-20%). More
than 50% of children with LUTS are affected with Functional Constipation (Bowel Bladder Dysfunction, BBD).
The aim was to investigate with non invasive integrated urodynamic studies (according to ICCS), the voiding parameters
in children with BBD, following non invasive urodynamic method and Rome III criteria.
MATERIAL AND METHODS
This study included 25 patients with BBD (16 male and 9 female, mean age: 8.28 years).
All these patients received a non-invasive integrated study, compilation of frequency/volume chart and gastroenterologic
approach with Bristol stool form scale (BSC), completed from uroflowmetry with ultrasound study of bladder with
maximum cystometric capacity (MCC), post-void residual urine volume (PVR) and rectal diameter (DR). We also
described the presence of eventual dilated ureters. The uroflowmetry with US evaluation was performed two times for
each patient.
RESULTS
17/25 (68%) patients had constipation (BSC score <3), among them:
- 10 (59%) had a bladder volume above normal for age,
- 4 (23.5%) had encopresis,
- 13 (76.5%) had DR >3 cm and MCC was 112% higher than expected (p=0.03),
- 2 (11.75%) had DR = 2,5-3 cm.
9/25 patients (36%) had detrusor-sphincter dyssynergia; among them 7 (77.7%) had a PVR >10%.
12/25 had a low BSC score (≤2); among them, 8 (66.6%) had abnormal voiding frequency (<4/24h, p=0.024).
10/25 patients (40%) had recurrent urinary tract infections and 40% of them had dilatation of the upper urinary tract
(p=0,017).
CONCLUSIONS
We obtain a significant correlation between patients with DR >3 cm and patients with abnormal MCC. Low voiding
frequency and constipation are strongly correlated (p=0.024).
This non invasive urodynamic integrated approach is inexpensive, sensitive, well accepted and could better explain in
future the etiology and physiopathology of BBD.