Mp21-08 Can Videourodynamics Shape Management in Refractory Pediatric Lower Urinary Tract Dysfunction?

You have accessJournal of UrologyPediatrics II (MP21)1 May 2024MP21-08 CAN VIDEOURODYNAMICS SHAPE MANAGEMENT IN REFRACTORY PEDIATRIC LOWER URINARY TRACT DYSFUNCTION? Jason P. Van Batavia, Katherine Fischer, Monica Moran, Joy Kerr, Adriana Messina, Keely McClatchy, Dana Weiss, Christopher Long, and Stephen A. Zderic Jason P. Van BataviaJason P. Van Batavia , Katherine FischerKatherine Fischer , Monica MoranMonica Moran , Joy KerrJoy Kerr , Adriana MessinaAdriana Messina , Keely McClatchyKeely McClatchy , Dana WeissDana Weiss , Christopher LongChristopher Long , and Stephen A. ZdericStephen A. Zderic View All Author Informationhttps://doi.org/10.1097/01.JU.0001008844.84871.17.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Lower urinary tract dysfunction (LUTD) remains a common reason for pediatric urology consultation, and the management of these patients is time consuming and frustrating for patients, families and providers alike. But what happens when the patient proves refractory to current treatment modalities? Is there a role for the use of videourodynamics (VUDS) to help guide therapy in the patient with refractory voiding dysfunction, and if so how might we select patients for this invasive study in order to increase the yield of useful information? OBJECTIVES: To determine the role, if any, for VUDS in the evaluation of pediatric patients with refractory LUT dysfunction and to identify parameters that might be used to select patients for this invasive study in order to increase the yield of useful information. METHODS: Through our IRB-approved prospectively maintained urodynamics database, we retrospectively identified 110 patients with non-neurogenic LUTD over a period from 2015 to 2022 who underwent VUDS. We excluded patients with known neurologic or anatomic lesions and developmental delay. RESULTS: There were 76 females and 34 males (69%/31%) and their average age at the time of the study was 10.5 years +/-4 with a median age of 7.3 years. Patients had been followed for a mean of 5.9+/-3.5 office visits prior to obtaining the VUDS and reported a mean Dysfunction Voiding and Incontinence Symptom Score (DVISS) of 15.6±6.7 before the VUDS. VUDS resulted in a change in management in 86 of these 110 patients (78%). Management changes included a change in medication (53/110), consideration of CIC (11/110), PTNS (1/110) and surgery (14/110). As shown in the Figure 1, the DVISS score was significantly higher and the number of office visits prior to VUDS was significantly higher in the 86 patients whose management was changed versus the 24 patients in whom management did not change (p<0.02). CONCLUSIONS: Proposed criteria for selecting LUTD patients for VUDS include: 1) long standing urinary incontinence refractory to medications, 2) ≥6 visits to LUTD clinic with no improvement, and 3) LUT symptom score of ≥16. Our findings suggest these criteria identify a cohort of patients in which a VUDS evaluation for the child with refractory LUTD can offer a more exact diagnosis that can shape management. Download PPT Source of Funding: This work was supported in part by the Urology Care Foundation Rising Stars in Urology Research Award Program and Frank and Marion Hinman Urology Research Fund (JPV), and the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under Award Number K08DK120934 (JPV). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e332 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Jason P. Van Batavia More articles by this author Katherine Fischer More articles by this author Monica Moran More articles by this author Joy Kerr More articles by this author Adriana Messina More articles by this author Keely McClatchy More articles by this author Dana Weiss More articles by this author Christopher Long More articles by this author Stephen A. Zderic More articles by this author Expand All Advertisement PDF downloadLoading ...