Abstract:
Objective: The urodynamics aim is to establish the nature and causes of urinary symptoms at little
patient after the vesico-urethral maturation.
Material and Methods: During 1996 and 2000 were studied in our center 54 children aged between 4 and 14 years, most of them admitted in «M.S. Curie» Pediatric Hospital from Bucharest. 70% were
surgically treated in Center of Urological Surgery, Dialysis and Renal Transplantation (Prof. I. Sinescu)
or at the Pediatric Surgical Department (Prof. Pesamosca). The urodynamic studies on children are
more complicated than on adults due to the necessity of special equipment, active presence of
urodynamic specialist and the pediatric also.
Results: The urodynamic disorders' maximum incidence appear after the age of 4 years when the
bladder volume is adequate and the neurological center controlled the voluntary urethral sphincter
and the detrusor contractility. Therefore, there were identified as causes: persistent urinary infections
(80 cases), micturition difficulty or urine loss (60% cases) due to the congenital urinary malformations
or neurological diseases (30% cases), sometimes mixed through their complexity (10%). The urodynamic investigation consists on: flowmetry, cystometry, EMG of the pelvic floor, combined studies
including micturitional cystography, and in special cases were evaluated the detrusor and the bladder neck, the eventual vesico-ureteral ebb tide or other pathological causes (urethral valves, fisulas,
ureterocel, etc). Conclusions: The urodynamic studies on child's persistant urinary disorders are strictly necessary
for diagnosis and treatment to follow establishment, especially when there indicated surgical in te rventions are required to correct some complexe urinary and neurologic malformations.
