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The Pseudo‐obstructed Bladder in Enuretic Children
Author(s) -
JOHNSTON J. H.,
KOFF S. A.,
GLASSBERG K. I.
Publication year - 1978
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1978.tb06201.x
Subject(s) - medicine , vesicoureteric reflux , urology , sphincter , reflux , detrusor muscle , urinary system , urinary bladder , surgery , disease
Summary— In a minority of enuretic children with severe day symptoms, and especially when there is urinary infection, there are bladder diverticula and trabeculation and possibly also harmful vesicoureteric reflux which suggest the presence of an infravesical obstruction. However, in 11 children with this syndrome who underwent urodynamic studies, no anatomical or functional obstruction was demonstrable. It is contended that the obstructive signs are the result of uninhibited detrusor contractions being voluntarily resisted by contraction of the external urethral sphincter so that abnormally high intravesical pressures result. Management involves the use of detrusor‐inhibitory drugs. Ureteric reimplantation may be needed for reflux. In the majority of cases symptoms improve with time but the bladder diverticula persist.