Department of Pediatric Urology, Faculty of Medicine, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Türkiye.
Department of Pediatric Surgery, Faculty of Medicine, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Türkiye.
Neurourol Urodyn. 2024 Feb;43(2):390-395. doi: 10.1002/nau.25375. Epub 2024 Jan 2.
Urodynamic studies (UDSs) play a crucial role in evaluating lower urinary tract function in pediatric patients with neurogenic bladder. However, the influence of patient position on urodynamic parameters in this population remains understudied. This study aims to investigate the effect of patient position on urodynamic results in children with neurogenic bladder.
A prospective study was conducted with 50 pediatric patients diagnosed with neurogenic bladder. Urodynamic recordings were obtained during a single session, with the first two fillings in the supine position and the third filling in the sitting position. Urodynamic parameters assessed included detrusor overactivity (DO), maximum detrusor pressure (MDP), cystometric bladder capacity (CBC), compliance (C), detrusor leak point pressure (DLPP), and bladder volume at the moment of incontinence (DLPV).
Patient position did not significantly influence CBC, DO, C, and DLPV (p > 0.05). However, there were significant differences in MDP and DLPP between the supine and sitting positions (p < 0.05), with higher values observed in the supine position.
These findings highlight the importance of considering the patient's position when interpreting urodynamic results and making treatment decisions for children with neurogenic bladder. The higher MDP and DLPP values in the supine position may have clinical implications for assessing upper urinary tract integrity and treatment planning. However, further research is needed to understand the underlying mechanisms and generalize these findings to broader patient populations.
尿动力学研究(UDS)在评估神经源性膀胱患儿下尿路功能方面起着至关重要的作用。然而,患者体位对该人群尿动力学参数的影响仍研究不足。本研究旨在探讨患者体位对神经源性膀胱患儿尿动力学结果的影响。
进行了一项前瞻性研究,纳入了 50 例诊断为神经源性膀胱的儿科患者。在单次检查中进行尿动力学记录,前两次充盈时取仰卧位,第三次充盈时取坐位。评估的尿动力学参数包括逼尿肌过度活动(DO)、最大逼尿肌压力(MDP)、膀胱容量测压(CBC)、顺应性(C)、逼尿肌漏点压(DLPP)以及失禁时的膀胱容量(DLPV)。
患者体位对 CBC、DO、C 和 DLPV 无显著影响(p>0.05)。然而,仰卧位和坐位之间的 MDP 和 DLPP 存在显著差异(p<0.05),仰卧位时值较高。
这些发现强调了在解释神经源性膀胱患儿的尿动力学结果并做出治疗决策时考虑患者体位的重要性。仰卧位时较高的 MDP 和 DLPP 值可能对评估上尿路完整性和治疗计划具有临床意义。然而,需要进一步研究以了解潜在机制并将这些发现推广到更广泛的患者群体。