PRIMARY BLADDER NECK DYSFUNCTION IN CHILDREN AND ADOLESCENTS I: PELVIC FLOOR ELECTROMYOGRAPHY LAG TIME—A NEW NONINVASIVE METHOD TO SCREEN FOR AND MONITOR THERAPEUTIC RESPONSEстатья из журнала
Аннотация: No AccessJournal of UrologyPediatric Urology1 Jan 2005PRIMARY BLADDER NECK DYSFUNCTION IN CHILDREN AND ADOLESCENTS I: PELVIC FLOOR ELECTROMYOGRAPHY LAG TIME—A NEW NONINVASIVE METHOD TO SCREEN FOR AND MONITOR THERAPEUTIC RESPONSE ANDREW J. COMBS, NEIL GRAFSTEIN, MARK HOROWITZ, and KENNETH I. GLASSBERG ANDREW J. COMBSANDREW J. COMBS Current address: Weill-Cornell Children's Hospital of New York-Presbyterian, New York, New York 10021 More articles by this author , NEIL GRAFSTEINNEIL GRAFSTEIN Current address: State University of New York Downstate Medical Center, Brooklyn, New York 11203 More articles by this author , MARK HOROWITZMARK HOROWITZ Current address: Weill-Cornell Children's Hospital of New York-Presbyterian, New York, New York 10021 More articles by this author , and KENNETH I. GLASSBERGKENNETH I. GLASSBERG More articles by this author View All Author Informationhttps://doi.org/10.1097/01.ju.0000147269.93699.5aAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: One of the key findings for making the diagnosis of primary bladder neck dysfunction (PBND) on videourodynamics (VUDS) is prolongation of the time between the start of a voluntary detrusor contraction and the start of urine flow (opening time). Since normally this dynamic event is immediately preceded by pelvic floor relaxation, we determined if the interval between pelvic floor relaxation on pelvic floor electromyography (EMG) and the start of flow (pelvic floor EMG lag time), approximated opening time. Materials and Methods: Opening time measured on VUDS and pelvic floor EMG lag time measured on noninvasive uroflowmetry/EMG were compared in 22 consecutive patients with a mean age of 13.8 years diagnosed with PBND and a control group of 17 normal children. In addition, 19 patients with PBND were placed on α-blocker therapy, and pretreatment and on treatment uroflowmetry and pelvic floor EMG lag time values were compared. Results: Mean opening time and mean pelvic floor EMG lag time were statistically indistinguishable from each other in the PBND and normal groups (27.4 vs 23.9 and 1.1 vs 1.3 seconds, respectively, p >0.550), but they differed significantly between the normal and PBND groups (p <0.001). On α-blocker therapy a decrease in mean pelvic floor EMG lag time from 24.47 to 6.67 seconds (p <0.001) corresponded with improved flow parameters, while no improvement was noted in untreated patients. Conclusions: Pelvic floor EMG lag time directly correlates with opening time and, when prolonged and associated with abnormal uroflowmetry, it is highly suggestive of PBND, thereby, justifying more invasive evaluation with VUDS or the initiation of empirical drug therapy. Most importantly, it provides an objective means of monitoring treatment response in a disorder that often has lingering symptoms. References 1 : Lower urinary tract symptoms in young men: videourodynamic findings and correlation with noninvasive measures. J Urol2002; 168: 135. Link, Google Scholar 2 : Etiology of voiding dysfunction in men less than 50 years of age. Urology1996; 47: 836. Google Scholar 3 : α1-Adrenergic blockers in young men with primary bladder neck obstruction. J Urol2002; 168: 571. Link, Google Scholar 4 : Urodynamic evidence of vesical neck obstruction in men with misdiagnosed chronic nonbacterial prostatitis and the therapeutic role of endoscopic incision of the bladder neck. 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Link, Google Scholar From the Divisions of Pediatric Urology, State University of New York Downstate Medical Center, Brooklyn and Children's Hospital of New York-Presbyterian (Weill-Cornell and Columbia University Divisions), New York, New York© 2005 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byLordêlo P (2019) How Should we Measure Lower Urinary Tract Dysfunction in Children?Journal of Urology, VOL. 201, NO. 3, (459-460), Online publication date: 1-Mar-2019.Austin P, Bauer S, Bower W, Chase J, Franco I, Hoebeke P, Rittig S, Vande Walle J, von Gontard A, Wright A, Yang S and Nevéus T (2014) The Standardization of Terminology of Lower Urinary Tract Function in Children and Adolescents: Update Report from the Standardization Committee of the International Children's Continence SocietyJournal of Urology, VOL. 191, NO. 6, (1863-1865.e13), Online publication date: 1-Jun-2014.Combs A, Van Batavia J, Chan J and Glassberg K (2013) Dysfunctional Elimination Syndromes—How Closely Linked are Constipation and Encopresis with Specific Lower Urinary Tract Conditions?Journal of Urology, VOL. 190, NO. 3, (1015-1020), Online publication date: 1-Sep-2013.Combs A, Van Batavia J, Horowitz M and Glassberg K (2013) Short Pelvic Floor Electromyographic Lag Time: A Novel Noninvasive Approach to Document Detrusor Overactivity in Children with Lower Urinary Tract SymptomsJournal of Urology, VOL. 189, NO. 6, (2282-2286), Online publication date: 1-Jun-2013.Van Batavia J, Combs A, Hyun G, Bayer A, Medina-Kreppein D, Schlussel R and Glassberg K (2011) Simplifying the Diagnosis of 4 Common Voiding Conditions Using Uroflow/Electromyography, Electromyography Lag Time and Voiding HistoryJournal of Urology, VOL. 186, NO. 4S, (1721-1727), Online publication date: 1-Oct-2011.Glassberg K, Combs A and Horowitz M (2010) Nonneurogenic Voiding Disorders in Children and Adolescents: Clinical and Videourodynamic Findings in 4 Specific ConditionsJournal of Urology, VOL. 184, NO. 5, (2123-2127), Online publication date: 1-Nov-2010.Kajbafzadeh A, Baradaran N, Sadeghi Z, Tourchi A, Saeedi P, Madani A, Ataei N, Taghavinejad A and Mohsseni M (2010) Vesicoureteral Reflux and Primary Bladder Neck Dysfunction in Children: Urodynamic Evaluation and Randomized, Double-Blind, Clinical Trial on Effect of α-Blocker TherapyJournal of Urology, VOL. 184, NO. 5, (2128-2133), Online publication date: 1-Nov-2010.Van Batavia J, Combs A, Horowitz M and Glassberg K (2009) Primary Bladder Neck Dysfunction in Children and Adolescents III: Results of Long-Term α-Blocker TherapyJournal of Urology, VOL. 183, NO. 2, (724-730), Online publication date: 1-Feb-2010.Franco I (2007) Overactive Bladder in Children. Part 2: ManagementJournal of Urology, VOL. 178, NO. 3, (769-774), Online publication date: 1-Sep-2007. Volume 173Issue 1January 2005Page: 207-211 Advertisement Copyright & Permissions© 2005 by American Urological Association, Inc.Keywordsbladder neck obstructionbladderelectromyographymuscle contractionurodynamicsMetricsAuthor Information ANDREW J. COMBS Current address: Weill-Cornell Children's Hospital of New York-Presbyterian, New York, New York 10021 More articles by this author NEIL GRAFSTEIN Current address: State University of New York Downstate Medical Center, Brooklyn, New York 11203 More articles by this author MARK HOROWITZ Current address: Weill-Cornell Children's Hospital of New York-Presbyterian, New York, New York 10021 More articles by this author KENNETH I. GLASSBERG More articles by this author Expand All Advertisement PDF downloadLoading ...
Год издания: 2005
Издательство: Lippincott Williams & Wilkins
Источник: The Journal of Urology
Ключевые слова: Pelvic floor disorders treatments, Urinary Bladder and Prostate Research, Urological Disorders and Treatments
Другие ссылки: The Journal of Urology (HTML)
PubMed (HTML)
PubMed (HTML)
Открытый доступ: closed
Том: 173
Выпуск: 1
Страницы: 207–211