260 / 330
260
28
TH
CONGRESS OF THE ESPU
management involved everyday enemas, laxative application and a special dietary regimen, with
an aim of treating constipation and fecal incontinence that was determined according to Roma III
criteria. The effects of the administered bowel management on urinary incontinence were assessed
on the basis of the maximum dry time interval between two CICs.
RESULTS
In the group with adminstered bowel management, the average maximum dry interval between two
CICs is 125.2 minutes +/- 52.02 SD, whereas in the group treated only with CIC and anticholinergic
medication therapy, the average maximum dry interval is 93.0 minutes +/- 47.33 SD. The t-test
application proved that there is a statistical difference regarding urinary incontinence, i.e. maximum
dry interval between these two patient groups (p <0.05).
CONCLUSIONS
Adminstering bowel management considerably alleviates symptoms of urinary incontinence, be-
cause of which it should be an integral part of treating patients with spina bifida.
12:22–12:25
S24-7 (PP)
NEUROGENIC BLADDER: URODYNAMIC
ULTRASSONOGRAPHY ACURACY
IN MYELOMENINGOCELE CHILDREN
Tiago ROSITO
1
, Tiago BORTOLINI
1
, Iara LUCENA
2
, Nelson BATESINI
1
,
Nicolino ROSITO
3
, Bruna Brasil CARNEIRO
1
, Anderson CASTRO DE SOUZA
1
,
Patric TAVARES
1
and Brasil SILVA NETO
4
1) Federal University of Rio Grande do Sul, Pediatric and Reconstructive Urology, Porto Alegre, BRAZIL - 2) Federal
University of Rio Grande do Sul, Radiology, Porto Alegre, BRAZIL - 3) FFFCMPA, Pediatric and Reconstructive Urology,
Porto Alegre, BRAZIL - 4) Federal University of Rio Grande do Sul, Urology, Porto Alegre, BRAZIL
PURPOSE
Myelomeningocele (MMC) is an important cause of urinary tract dysfunction. Urodynamics is the
gold-standard for vesical function assessment, being essential to therapeutic decisions. The feasi-
bility of an alternative non-invasive procedure to replace it, is the purpose of this study.
MATERIAL AND METHODS
We performed standard urodynamic exams simultaneously with urodynamic ultrasound in 62 MMC
patients from January/2015 to July/2016. Urodynamic was made by standard technic, without seda-
tives or anesthesia procedures, simultaneously with Urodynamic ultrasound, focusing on bladder
behavior during filling fase, analyzing the presence of involuntary detrusor activity, cystometric
capacity , thickness of the bladder wall, bladder neck behavior and incontinence.
RESULTS
Mean age was 7.04 years old, 54.8% being male. 93,5% carried ventriculoperitoneal shunt. Chronic
kidney disease was present in 6.4%, recurrent urinary tract infection in 17.7% and constipation
in 71%. Anticholinergic therapy was in course of 48.4%. Urodynamic parameters evaluated were
detrusor overactivity (positive in 43.5%), compliance (decreased in 48,3%) and cystometric capacity
(normal in 59,7%). Ultrasound identified involuntary detrusor activity in 48,4% of these patients.
Considering urodynamics the gold standard to identify detrusor overactivity, ultrasound achieved
92,6% sensitivity, 85,7% specificity, positive predictive value of 83,3%, negative predictive value
of 93.7%, 88.7% of accuracy and Kappa 0,76. Correlation between urodynamics and ultrasound
findings for detrusor overactivity occurred in 55 pacients of this population.