Natural fill urodynamics and conventional cystometrogram in infants with neurogenic bladder.

Abstract

We compared findings from natural fill urodynamics and conventional cystometrogram in infants with neurogenic bladder. We retrospectively analyzed data from 19 infants undergoing 24-hour natural fill urodynamics and cystometrogram. The infants concurrently underwent ultrasound. Voided volume, detrusor overactivity, area under the curve (per minute) and baseline detrusor pressure obtained at natural fill urodynamics were compared to cystometric capacity, detrusor overactivity, leak point pressures and bladder compliance obtained at cystometrogram. Voided volumes during natural fill urodynamics were significantly less than cystometric capacity volumes (p <0.001). Natural fill urodynamics revealed more detrusor overactivity than did cystometrogram. Four infants with leak point pressures greater than 40 cm H2O had detrusor overactivity at natural fill urodynamics. Five patients with leak point pressure less than 40 cm H2O had no detrusor overactivity at natural fill urodynamics or cystometrogram. Four of 5 infants with decreased bladder compliance had baseline detrusor pressure greater than 10 cm H2O and detrusor overactivity. Urodynamic parameters obtained at natural fill urodynamics may be associated with cornerstone parameters such as leak point pressure and bladder compliance obtained at cystometrogram.