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Int Neurourol J. 2016 Mar;20(1):53-8. doi: 10.5213/inj.1630392.196. Epub 2016 Mar 30.

Weakness of the Pelvic Floor Muscle and Bladder Neck Is Predicted by a Slight Rise in Abdominal Pressure During Bladder Filling: A Video Urodynamic Study in Children.

International neurourology journal

Sang Hee Shin, Young Jae Im, Yong Seung Lee, Jang Hwan Kim, Sang Won Han

Affiliations

  1. Bladder-Urethral Rehabilitation Clinic, Department of Pediatric Urology, Severance Children's Hospital, Yonsei University Health System, Seoul, Korea.
  2. Department of Urology, Urological Science Institute, Yonsei University of College of Medicine, Seoul, Korea.

PMID: 27032558 PMCID: PMC4819155 DOI: 10.5213/inj.1630392.196

Abstract

PURPOSE: To investigate the significance of slowly rising abdominal pressure (SRAP), which is often observed in nonneurogenic children during bladder filling in video urodynamic studies (VUDSs).

METHODS: The records of patients who underwent VUDS from July 2011 to June 2013 were reviewed. SRAP was defined as a rising curve over 5 cm H2O from the baseline abdominal pressure during the filling phase in VUDS. Bladder descent was defined when the base of the bladder was below the upper line of the pubic symphysis. An open bladder neck was defined as the opening of the bladder neck during the filling phase.

RESULTS: Of the 488 patients, 285 were male patients. The mean age at VUDS was 3.7 years (range, 0.2-17.6 years). The VUDS findings were as follows: SRAP, 20.7% (101 of 488); descending bladder, 14.8% (72 of 488); and bladder neck opening, 4.3% (21 of 488). Of the 72 patients with a descending bladder, 84.7% had SRAP. A significant difference in the presence of SRAP was found between the descending bladder and the normal bladder (P<0.001). Of the 101 patients with SRAP, 40 (39.6%) did not have a descending bladder. Of the 40 patients, 14 (35.0%) had a bladder neck opening, which was a high incidence compared with the 4.3% in all subjects (P<0.001).

CONCLUSIONS: SRAP was associated with a descending bladder or a bladder neck opening, suggesting that SRAP is a compensatory response to urinary incontinence. SRAP may also predict decreased function of the bladder neck or pelvic floor muscle.

References

  1. Arch Dis Child. 1987 Feb;62(2):128-31 - PubMed
  2. Neurourol Urodyn. 2011 Sep;30(7):1253-7 - PubMed
  3. Neurourol Urodyn. 2010 Mar;29(3):418-23 - PubMed
  4. J Urol. 1999 Jun;161(6):1871-4 - PubMed
  5. Scand J Urol Nephrol. 2011 Nov;45(5):300-5 - PubMed
  6. J Formos Med Assoc. 2003 Jan;102(1):23-9 - PubMed
  7. Acta Obstet Gynecol Scand Suppl. 1990;153:7-31 - PubMed
  8. J Urol. 2006 Jul;176(1):314-24 - PubMed
  9. AJR Am J Roentgenol. 1996 Mar;166(3):561-5 - PubMed
  10. J Dev Behav Pediatr. 2009 Oct;30(5):385-93 - PubMed
  11. Am J Obstet Gynecol. 1994 Jun;170(6):1713-20; discussion 1720-3 - PubMed
  12. Int Urogynecol J Pelvic Floor Dysfunct. 1997;8(2):69-73 - PubMed
  13. Dan Med Bull. 1983 Mar;30(2):66-84 - PubMed
  14. Pediatrics. 1999 Jun;103(6 Pt 2):1359-68 - PubMed
  15. J Pediatr Surg. 1991 Jan;26(1):55-7 - PubMed

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