Table urodynamics with ureteral occlusion: a resource for measuring bladder capacity and compliance in the management of patients with macroscopic vesicoureteral reflux

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Neurourol Urodyn. December 9, 2021. doi: 10.1002 / nau.24847. Online ahead of print.


OBJECTIVE: To describe a table urodynamic technique with ureteral occlusion (OUUO) and to present a series of cases comparing bladder capacity and pressure measurements performed with and without ureteral occlusion in patients with macroscopic vesicoureteral reflux ( grade ≥ IV VUR) to demonstrate clinical utility.

METHODS: We performed OUUO in seven patients who were considered for surgical management of VUR and / or nephro-ureterectomy. We occluded the refluxing ureters using hysterosalpingography catheters (HSG, 5.5 Fr single lumen catheter with 1.5 ml balloon), guidewires, and a rigid cystoscope. A 6 Fr dual lumen urodynamic catheter (DU) is then inserted into the bladder to perform OUUO. Bladder capacity and compliance (C = bladder volume / detrusor pressure) are recorded and compared to the values ​​obtained in standard DU (without ureteral occlusion).

RESULTS: The age range of the seven patients was 2.0 to 15.5 years. The etiology of macroscopic RVU was posterior urethral valve (PUV) and neuropathic. Bladder capacity and compliance between UD and OUUO results were comparable in five patients. However, there was a clinically significant difference in bladder capacity (20% to 50% decrease) and adherence (50% to 90%) between DU and OUUO results in two patients. on seven.

CONCLUSION: In the presence of crude VUR, OUUO allows a potentially more accurate assessment of bladder capacity and compliance. OUUO should be taken into account when planning the dilation / reimplantation of the ureteral opening and nephro-ureterectomy.

PMID: 34888917 | DOI: 10.1002 / nau.24847

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