Influence of Urethral Sphincter Incompetence on Bladder Shape and Function in Myelodysplastic Children
Article first published online: 29 JAN 2010
© 2010 Blackwell Publishing Asia Pty Ltd
LUTS: Lower Urinary Tract Symptoms
Volume 2, Issue 1, pages 27–30, April 2010
How to Cite
YOKOYAMA, O., ITO, H. and NAMIKI, M. (2010), Influence of Urethral Sphincter Incompetence on Bladder Shape and Function in Myelodysplastic Children. LUTS: Lower Urinary Tract Symptoms, 2: 27–30. doi: 10.1111/j.1757-5672.2010.00056.x
- Issue published online: 13 APR 2010
- Article first published online: 29 JAN 2010
- Received 12 August 2009; revised 26 October 2009; accepted 3 November 2009.
- bladder diseases;
- myelodysplastic syndromes;
- urethral sphincter;
- urinary catheterization
Objectives: This study was undertaken to investigate the influence of the urethral function on bladder shape and function in myelodysplastic children.
Methods: Of 39 myelodysplastic children, 30 were treated with intermittent catheterization. The diagnosis of internal sphincter incompetence (SI) was based on cystographic findings (open bladder neck) and that of external SI on urodynamic findings (underactive external sphincter identified on electromyography and maximum urethral closure pressure of less than 50 cm H2O). Follow up included evaluation of bladder deformity and compliance.
Results: The mean observation period was 8.6 years. In the 11 patients with external SI, bladder deformity and compliance significantly improved as a result of intermittent catheterization. However, of 12 patients with overactive sphincter and/or closure pressure of 50 cm H2O or more, eight showed deterioration or no improvement in bladder deformity, and three showed upper urinary tract deterioration.
Conclusion: These results indicate that an increase in urethral resistance may lead to deterioration of bladder shape.