To investigate the correlation between urethral instability (URI) and overactive bladder (OAB) in children.
We retrospectively investigated 126 children with OAB and 36 children without OAB using synchro-cystourethrometry. The prevalence of detrusor overactivity (DO) and URI, and the diagnostic sensitivity of DO alone and DO combined with URI, was compared. The OAB children with URI voluntarily received transcutaneous electrical pudendal nerve stimulation with anisodamine (stimulation group, SG) or anisodamine alone (non-stimulation group, NSG). The effectiveness of treatment was evaluated. Average voided volume (AVV), maximum voided volume (MVV), and number of voids per day (NV) were collected and analyzed.
In OAB children, the prevalence of DO and URI was 51.6 and 32.5%, respectively. The prevalence of URI was 5.6% in controls. The prevalence of URI was significantly higher in OAB children. The diagnostic sensitivity and Youden index of DO combined with URI were higher than DO alone. In SG, 45.7% of children were cured, with a ≥ 50% improvement rate of 82.9%, while no child was cured, with a ≥ 50% improvement rate of 36.8% in NSG. A significant increase in AVV and MVV together, with a decrease in NV, was seen in SG. There was a significant difference in visual analogue scale values between SG and NSG (P < 0.01).
Urethral instability plays an essential role in the pathogenesis and progression of OAB in children. Synchro-cystourethrometry is a useful urodynamic technology to precisely diagnose OAB, and transcutaneous electrical pudendal nerve stimulation may be an effective treatment for OAB children induced by URI.
International urology and nephrology. 2018 Jan 03 [Epub ahead of print]
Chaoyang Hua, Yibo Wen, Yan Zhang, Quande Feng, Xiangfei He, Yunlong Li, Junwei Wu, Jinjin Feng, Stuart B Bauer, Jianguo Wen
Department of Urology, Pediatric Urodynamic Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China., Department of Urology, Boston Children's Hospital, Harvard Medical School, Boston, MA, 02215, USA., Department of Urology, Pediatric Urodynamic Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China. .