Ambulatory urodynamic studies (UDS) allow assessment of urinary bladder function by recording bladder events during natural filling and emptying.
The International Children's Continence Society supports the use of ambulatory UDS as a test of choice in children with bladder dysfunction. There are very few studies on ambulatory UDS in children leading to a paucity of data on its clinical usefulness. The present study reports a series of ambulatory UDS in children using a Bluetooth-enabled device that allows children to remain in familiar environment without the presence of healthcare personnel. Ambulatory UDS using a Bluetooth-enabled device improved treatment outcomes by enabling a more precise diagnosis in half of the children (six of 12) with refractory bladder dysfunction. Ambualtory UDS was found to be safe and well tolerated by children of all age groups.
OBJECTIVES: To report the early observations of using ambulatory urodynamic studies (UDS) using a Bluetooth-enabled device in children To evaluate the incremental value of ambulatory over conventional UDS.
PATIENTS AND METHODS: Ambulatory UDS were performed in selected children with voiding dysfunction between August 2009 and October 2010. Conventional UDS were concurrently performed wherever possible. The test results and treatment consequences of the two tests were compared.
RESULTS: In all, 12 ambulatory and seven conventional UDS were performed on 10 children (five boys, median [range] age 7 [4-16] years). Six of the seven children had a normal conventional UDS. Ambulatory UDS detected phasic detrusor overactivity (DO) in five children and generalised DO in one. Direct correlation of symptoms to DO was possible in two children during ambulatory UDS. Pressure rise during filling, seen in two children on conventional UDS, was not seen during ambulatory UDS. Five children showed clinical improvement when therapy was guided by ambulatory UDS results. Ambulatory UDS was generally well tolerated in eight children, with two complaining of discomfort. Inadequate information was obtained in two children who underwent ambulatory UDS due to technical problems in one and distress induced by the UDS in the other.
CONCLUSIONS: Ambulatory UDS provides useful additional information over conventional UDS and can be used to guide further therapy in selected children with voiding dysfunction. It is safe and well tolerated in children. There is a need for explicit guidance for the technical delivery and interpretation of ambulatory UDS in children.
Written by:
Deshpande AV, Craig JC, Caldwell PH, Smith GH. Are you the author?
Departments of Urology Nephrology Centre for Kidney Research, Children's Hospital at Westmead, School of Public Health Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Australia.
Reference: BJU Int. 2012 Dec;110 Suppl 4:38-45.
doi: 10.1111/j.1464-410X.2012.11475.x
PubMed Abstract
PMID: 23194124
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