Clinical features and association of bladder ultrasound findings and uroflowmetry with healing period of overactive bladder in children

Overactive bladder (OAB) is a symptomatic syndrome defined by urinary urgency, usually accompanied by increased urination frequency and nocturia, with or without urinary incontinence. The prevalence of pediatric OAB in 5-13 year olds is reported to be as high as 16. 6%, but the pathophysiology and epidemiology have not been sufficiently elucidated.

We retrospectively reviewed medical records in 117 children with OAB aged between 5 and 15 years during the years 2012 to 2016. At initial presentation, abdominal ultrasound examinations and uroflowmetry were performed, and behavioral modifications, such as timed voiding, and constipation therapy were initiated. If there was no response to them after 4 weeks, antimuscarinic treatment was added. We evaluated the clinical features of OAB and factors related to the healing period, which was defined as the period from the start of behavioral modifications to cure.

The average healing period was 11.9 ± 9.73 months. There was no significant difference in the healing period based on age, gender, percentage of urination frequency, nocturnal enuresis, and constipation. The healing period was significantly shorter in the group having a bladder wall thickness of ≥5 mm than in the group having a bladder wall thickness of ≤5 mm. Children with a tower-shaped curve on uroflowmetry had a significantly shorter healing period than those with a bell-shaped curve.

It was suggested that the bladder wall thickness measurement and the pattern of uroflow curves shape are related to the healing period of pediatric OAB. This article is protected by copyright. All rights reserved.

Pediatrics international : official journal of the Japan Pediatric Society. 2018 Apr 13 [Epub ahead of print]

Masaki Fuyama, Hirokazu Ikeda, Chisato Oyake, Yuta Onuki, Tsuneki Watanabe, Keiichi Isoyama

The Department of Pediatrics, Showa University, Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama, Kanagawa, Japan.