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19–22 APRIL, 2017, BARCELONA, SPAIN
S11-13 (P without presentation)
URODYNAMIC FEATURES OF CHILDREN
WITH REFRACTORY IDIOPATHIC OVERACTIVE BLADDER
Charlotte MELLING
1
, Nicholas WEBB
2
, Michaela BLUNDELL
3
, Paula WILLIAMSON
3
,
Victoria OZKAN
4
, Malcolm LEWIS
2
and Anju GOYAL
1
1) Royal Manchester Children’s Hospital, Department of Paediatric Urology, Liverpool, UNITED KINGDOM - 2) Royal
Manchester Children’s Hospital, Department of Paediatric Nephrology, Manchester, UNITED KINGDOM - 3) University
of Liverpool, Institute for Child Health, Clinical Trials Research Centre, Liverpool, UNITED KINGDOM - 4) The National
Institute for Health, Wellcome Trust Clinical Research Facility at Central Manchester University Hospitals NHS
Foundation, Manchester, UNITED KINGDOM
PURPOSE
Diagnosis of Idiopathic Overactive Bladder (IOAB) is based on clinical history, bladder diaries and
urodynamic study. While detrusor overactivity (DO) confirms IOAB, some children may have IOAB
features without DO. The aim of the study was to delineate the urodynamic findings in this group
of patients.
MATERIAL AND METHODS
27 participants enrolled in a Pilot RCT for children with refractory IOAB were included. Baseline
clinical characteristics, using a symptom assessment questionnaire (SAQ), medication histories
and pre-randomisation urodynamic features were prospectively collected and analysed. Data are
described using median and range unless stated otherwise.
RESULTS
27 patients aged 10(7-14)years underwent baseline urodynamics, medication data was available
in 21/27 and SAQ’s for 18/27. 100% had tried first line oral anti-cholinergic medication, 48% had
two, and 10% had three or more medications in the past. SAQ analysis revealed urinary daytime
frequency and wetting episodes of 9(5-16) and 5(3-7) respectively, with mean 4.7 wet nights/week.
The median maximum cystometric capacity was 255mls (EBC was 330mls), with 48% having low
bladder capacity. 25/27(93%) had DO and number of overactive contractions was 11(1-25). The
maximum pDet during overactivity was 45(17-164)cmH2O. Bladder compliance was 15(3-100)mls/
cmH2O, and was reduced in 37%.
CONCLUSIONS
This study provides an insight into the expected urodynamic findings in children with refractory
IOAB. Additionally, it can be helpful to all health care professionals involved in the assessment of
these challenging group of IOAB patients who do not have DO despite clinical features.