Premium
Feasibility of Urodynamic Study (Combined Cystometry and Electromyography of the External Urethral Sphincter) under General Anesthesia in Children
Author(s) -
Ameda Kaname,
Kakizaki Hidehiro,
Yamashita Tetsufumi,
omura Katsuya,
Shinno Yuichiro,
Kemmotsu Osamu,
Koyanagi Tomohiko
Publication year - 1997
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.1997.tb00135.x
Subject(s) - medicine , cystometry , electromyography , urethral sphincter , urodynamic studies , anesthesia , surgery , urinary incontinence , physical medicine and rehabilitation , urinary bladder
Background To assess the feasibility of urodynamic study under general anesthesia (GA) we performed electromyography of the external urethral sphincter (EUS‐EMG) on 73 children and cystometry (CM) alone on 10 children. Methods Subjects were divided into 3 groups. Those in groups I and II were suspected of having voiding dysfunction with (group I) or without (group II) overt neurospinal defects, while those in group III were thought to be functionally normal. EUS‐EMG was performed under light anesthesia following cystourethroscopy to examine structural abnormalities. Atropine sulfate premedication was not used for the anesthetic procedure; muscle relaxants were used only for tracheal intubation. Results Voiding was observed in 83% of the patients. Among patients who voided, detrusor‐external sphincter dyssynergia (DSD) was noted in 7 (38%) group I patients and 6 (19%) group II patients; in group III, voiding was synergic in all patients. In 10 cases, CM alone was carried out both under anesthesia and in the waking state; anesthesia suppressed detrusor hyperreflexia (DH) in all 9 patients but produced no change in bladder compliance. Conclusions In children with urinary disorders, urodynamic study under GA following cystourethroscopy is a feasible method for assessing EUS function and documenting DSD; DH is not evaluable, however. Stratifying urinary management on the basis of these examinations resulted in satisfactory clinical outcomes.