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Urodynamics and Other Investigations: When and How

Aktivitet: Tale eller præsentation - typerForedrag og mundtlige bidrag

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Jens Christian Djurhuus - Foredragsholder

  • Klinisk Institut

The approach to investigation of the bedwetting child, after significant daytime symptoms have been excluded, is predominantly none-invasive. This means that urodynamics may very seldom be used, and only in treatment of refractory children. Even then the use of urodynamics may be disputed. When this is said, the role of urodynamics may vary from centre to centre, depending on whether the clientele is on the first, second or tertiary referral level. In our setting, which is on the first to second level, and where approximately ⅔ of the patients have bedwetting without overt daytime symptoms, urodynamics is practically never used. And when it is used it may be confined to flow measurements, supplemented by residual urine estimation. If, on the other hand, urodynamics is indicated, then it is our opinion that it should be used in its full extent, but only performed by highly skilled people in places where cutting edge technology is available. And one has to be aware of that in these highly selected cases urodynamics may have to be repeated during the course or after treatment.

Therefore, in our opinion, a supra-pubic approach to the bladder should be used ensuring corporation and extension of the study when necessary.

Of paramount importance is the voiding diary for at least three days optionally, supplemented by a fluid intake measurement, and even more optionally urine chemistry, which seems to be more and more necessary in order to differentiate between different bedwetting etiologies.

Ultrasound investigation of the upper urinary tract in a primary or secondary referral clientele seems to be rather unnecessary since pathology is rare and when found rather insignificant.

An algorithm for investigation leading to the urodynamic investigation and its technique will be presented. 

2 dec. 2007

Begivenhed (Konference)

TitelICCS Course - International Enuresis Symposium
Dato02/12/200702/12/2007
EmneEvaluation of enuresis children
ByShatin
Land/OmrådeHong Kong

ID: 8274048