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Is 40 cm H 2 O detrusor leak point pressure cut‐off reliable for upper urinary tract protection in children with myelodysplasia?
Author(s) -
Tarcan Tufan,
Sekerci Cagri Akin,
Akbal Cem,
Tinay Ilker,
Tanidir Yiloren,
Sahan Ahmet,
Sahin Bahadir,
Top Tuncay,
Simsek Ferruh
Publication year - 2017
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.23017
Subject(s) - medicine , urinary system , cohort , urology , upper urinary tract
Purpose The purpose of this study, is to find out the most accurate cut‐off level for the detrusor leak point pressure (DLPP) in terms of upper urinary tract (UUT) protection in a cohort of children with myelodysplasia. Materials and Methods One hundred and ninety‐three children with myelodysplasia were included in the study based on the availability of urological evaluation at age of 3 years. Children were assigned to one of two groups—those who had UUT damage at age 3 (group 1, n: 70) and those without UUT changes (group 2, n: 123), and compared. Results Urological follow‐up data revealed higher incidences of febrile urinary tract infections and secondary tethering of the spinal cord in group 1. No statistically significant difference was determined between group 1 and group 2 in terms of DLPP values (median 42.5 vs. 39.5 cm H 2 O, respectively, P = 0.087). Analysis of different cut‐off values showed that DLPP above 20 cm H 2 O had a higher sensitivity for UUT damage (91.4%). A normal UUT was found in 56.5% and 62.2% of children with DLPP between 20 and 40 cm H 2 O, and with DLPP over 40 cm H 2 O, respectively. Conclusions Present study showed that more than half of the children with myelodysplasia had normal UUT function even with a DLPP of 40 cm H 2 O and over. Thus, DLPP, is not the sole decision making parameter to rely for more invasive therapies in children with myelodysplasia. On the other hand, a DLPP cut‐off value of 20 cm H 2 O showed a higher sensitivity to predict UUT damage instead of 40 cm H 2 O. Neurourol. Urodynam. 36:759–763, 2017 . © 2016 Wiley Periodicals, Inc.