OBJECTIVE: To evaluate the incidence and significance of the urodynamic registration of an after-contraction in the bladder of children. PATIENTS AND METHODS: In a prospective study, 250 children with a non-neurogenic voiding dysfunction (132 girls and 118 boys) were assessed for the occurrence of after-contractions during their video-urodynamic examination, and any filling-phase dysfunction noted. Twenty children in whom an after-contraction was recorded underwent additional voiding cystometry with three pressure transducers in the bladder (two microtip and one external transducer connected to a fluid-filled catheter). RESULTS: Of the 250 children, an after-contraction was registered in 84 (63 girls and 21 boys). Eighty of these had a filling-phase dysfunction; 51 had detrusor instability, 16 a hypersensitive bladder, six a low and seven a high compliance. Only four showed a normal cystometric pattern during filling. In the 20 children who underwent further study, the after-contraction was confirmed as a detrusor contraction, as it was registered simultaneously on three transducers of two types in 10 children and on two microtip transducers in another 10 children. CONCLUSION: The after-contraction is a frequent occurrence in children with voiding dysfunction, is related to bladder instability and is a genuine detrusor contraction.
OBJECTIVE: To evaluate the incidence and significance of the urodynamic registration of an after-contraction in the bladder of children. PATIENTS AND METHODS: In a prospective study, 250 children with a non-neurogenic voiding dysfunction (132 girls and 118 boys) were assessed for the occurrence of after-contractions during their video-urodynamic examination, and any filling-phase dysfunction noted. Twenty children in whom an after-contraction was recorded underwent additional voiding cystometry with three pressure transducers in the bladder (two microtip and one external transducer connected to a fluid-filled catheter). RESULTS: Of the 250 children, an after-contraction was registered in 84 (63 girls and 21 boys). Eighty of these had a filling-phase dysfunction; 51 had detrusor instability, 16 a hypersensitive bladder, six a low and seven a high compliance. Only four showed a normal cystometric pattern during filling. In the 20 children who underwent further study, the after-contraction was confirmed as a detrusor contraction, as it was registered simultaneously on three transducers of two types in 10 children and on two microtip transducers in another 10 children. CONCLUSION: The after-contraction is a frequent occurrence in children with voiding dysfunction, is related to bladder instability and is a genuine detrusor contraction.