Cystometry Techniques in Female Infants and Children
Cystometry is increasingly used in children, being an important diagnostic tool for congenital and acquired malformations such as neurogenic bladder, vesicoureteric reflux, urinary tract infection, urge syndrome, nocturnal enuresis, urinary incontinence and anorectal malformations. During cystometry bladder storage and voiding function can be evaluated. Carefully conducted urodynamic studies provide an insight into the pathophysiologic mechanisms involved in voiding dysfunctions that cannot be obtained by any other diagnostic technique. A variety of methods are available, the most sophisticated being filling and voiding cystometry with flowmetry and electromyography (EMG) under fluoroscopy, i.e. videocystometry. A detailed home recording of the frequency and volume of micturition can provide important clues as to the underlying bladder dysfunction, and can significantly aid in the choice of appropriate investigative techniques, as well as in the interpretation of subsequent urodynamic findings. It must be realized that urodynamic studies are invasive procedures and that artifacts may occur and influence the correct interpretation of the results. Infants and children have a different spectrum of bladder dysfunctions from adults and are generally much less cooperative during a urodynamic study. Therefore, cystometric techniques must be significantly modified. This article reviews cystometry techniques and their application in female infants and children. Cystometry/flow/EMG studies with or without fluoroscopy, ambulatory urodynamics and telemetric urodynamic measurement and their application are outlined.
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