Can Dynamic Ultrasonography Replace Urodynamics in Follow-up of Patients With Myelomeningocele

Hospital de Clinicas de Porto Alegre81 enrolled

Overview

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

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.

Study Type

INTERVENTIONAL

Allocation

Purpose

DIAGNOSTIC

Enrollment

Conditions

Neurogenic Bladder Myelomeningocele

Interventions

Dynamic UltrasonographyDIAGNOSTIC_TEST

Dynamic Ultrasonography was performed with patients in supine position, with a suprapubic sagittal position transductor, during filling phase of urodynamics.

Eligibility

Sex: ALLHealthy volunteers:

Medical Language ↔ Plain English

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

Outcomes

Primary Outcomes

To evaluate the accuracy of dynamic ultrasonography to identify bladder overactivity in neurogenic bladder.

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.

Time frame: 20 minutes

Secondary Outcomes

To evaluate the accuracy of dynamic ultrasonography to identify maximum cystometric capacity.

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.

Time frame: 20 minutes

To assess the ability of dynamic ultrasonography to estimate the pressure of detrusor contractions.

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.

Time frame: 20 minutes

Data from ClinicalTrials.gov

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