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19–22 APRIL, 2017, BARCELONA, SPAIN
S20-12 (P without presentation)
THE FATE OF LOW DLPP (< 30 CM H20) NEUROGENIC
BLADDER PATTERN THROUGHT YEARS
Antonio MACEDO JR
1
, João PARIZI
2
, Marcela LEAL DA CRUZ
2
, Jorge
Antonio POMPERMAIER
3
, Maria Isabel SILVA SILVA
4
, Sérgio OTTONI
2
,
Gilmar GARRONE
5
and Riberto LIGUORI
2
1) Federal University of Sao Paulo - Unifesp, Departament of Pediatrics, São Paulo, BRAZIL - 2) CACAU - Centro
De Apoio a Criança comAnomalia Urologica, Nupep, São Paulo, BRAZIL - 3) CACAU - Centro de Apoio a Criança
comAnomalia Urológica, Núcleo de Urologia Pediátrica - NUPEP, São Paulo, BRAZIL - 4) CACAU - Centro de Apoio
a Criança comAnomalia Urológica, NUPEP, Sao Paulo, BRAZIL - 5) CACAU - Centro de Apoio a Criança comAnomalia
Urologica, Nupep, São Paulo, BRAZIL
INTRODUCTION
Urodynamic evaluation (UE) is an excellent tool to categorize the bladder pattern of neurogenic
bladder and guide the most appropriate treatment. We can assume that patients with low DLPP
(detrusor leakage point pressure) will be presumably incontinent. However, bladder pattern may
change over time, and even in the considered low-risk patterns, regular assessment is required. We
proposed to review the evolution of the urodynamic pattern over time in patients initially classified
as incontinent.
MATERIAL AND METHODS
We reviewed data of 2 populations: group A (myelomeningocele - MMC patients that had postnatal
repair) and group B (MMC patients that had undergone in utero repair and are being followed
prospectively since November 2011). We consider only patients with DLPP equal or less than
30cmH2O. We reviewed first and last UE over the longest time of follow up to interpret changes of
pattern along time and have a better tool for parents education and assumption of need of future
surgery for urinary leakage.
RESULTS
We found 13 patients in groupAand 11 patients in group B. The mean initial DLPP was 24.3 cmH2O
(24.3 cmH2O postnatal and 24.4 cmH2O antenatal). Overactive bladder pattern was similarly
among groups (61.5% and 63.6% respectively). From the whole series 5 patients were excluded
from the analysis because they had only one UE. We defined the delta DLPP in cmH20 as the last
figure minus the first one in a delta t of 47 months follow-up. The variation of DLPP was +9.7 cm
H2O (8 cmH2O postnatal and 10.8 cmH2O antenatal).
CONCLUSIONS
Patients with low DLPP and a incontinence pattern do not show greater variation on leakage pres-
sure with a maximum range of 10 cmH20 of increase. This information is useful to advise patients
over the likelihood of a surgical procedure in the future for patients to become continent.