Myelomeningocele, Neurogenic Bladder
Conditions
Keywords
Dynamic Ultrasonography, Spinal Dysraphism
Brief summary
Patients with neurogenic bladder need periodic evaluation with urodynamic study, a invasive and uncomfortable procedure. Aim: To evaluate the accuracy of dynamic ultrasonography as a feasible and noninvasive alternative diagnostic method to identify detrusor overactivity in patients with neurogenic bladder
Detailed description
The urodynamic study and dynamic ultrasonography were performed concurrently, to identify detrusor overactivity, in patients with myelomeningocele and clinical indication for urodynamics, by investigators without verbal or visual contact. The overactivity was diagnosed through active conformational change of the bladder during filling phase.
Interventions
DIAGNOSTIC_TESTDynamic Ultrasonography
Dynamic Ultrasonography was performed with patients in supine position, with a suprapubic sagittal position transductor, during filling phase of urodynamics.
Sponsors
Hospital de Clinicas de Porto Alegre
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking description
Dynamic ultrasonography was performed during the filling phase of the urodynamic study. The radiologist and the urodynamicist had no verbal or visual contact during the examinations, with use of a siding.
Intervention model description
Dynamic ultrasonography was performed in all patients during the urodynamic study.
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
* All outpatients of the Pediatric Urology Department of the investigator's institution with diagnosis of myelomeningocele and clinical indication for urodynamic study
Exclusion criteria
* Previous bladder augmentation surgery * Current urinary tract infection * Fail to provide consent for participation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| To evaluate the accuracy of dynamic ultrasonography to identify bladder overactivity in neurogenic bladder. | 20 minutes | Dynamic Ultrasonography evaluated the dynamic conformational change of the bladder to identify the presence of detrusor overactivity, based on a subjective graduation of contractions, compared to the urodynamic data. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| To evaluate the accuracy of dynamic ultrasonography to identify maximum cystometric capacity. | 20 minutes | The bladder maximum capacity was measured at the end of the filling phase, based on the ellipse formula and compared to the infused volume in urodynamics. |
| To assess the ability of dynamic ultrasonography to estimate the pressure of detrusor contractions. | 20 minutes | According to the detrusor mobility and bladder deformity, the contractions were graded: 1 - no contractions; 2 - partial contraction of bladder floor; 3 - partial contraction of bladder floor and posterior wall; 4 - generalized contraction with modification of bladder shape from ellipsoid to round. These data were compared to the maximum pressure data recorded in the urodynamic study. |
Outcome results
None listed