MORBIDITY OF DYSFUNCTIONAL VOIDING SYNDROME

Objectives. External sphincter dyssynergia in the absence of an identi fiable causative neurologic lesion (dysfunctional voiding, Hinman-Alle n syndrome, non-neurogenic neurogenic bladder) has been known to cause significant morbidity. To determine the outcomes in this syndrome, we conducted a retrospective study of 37 patients referred for urodynami c studies and subsequently diagnosed with dysfunctional voiding. Metho ds. After diagnosis, follow-up was conducted through chart review and telephone calls to the primary physicians or the patients. Results. Fo llow-up was possible in 27 patients (17 female, 10 male; mean follow-u p 49 months, range 4 to 192). The average age at diagnosis was 12 year s; Eleven patients developed significant or ongoing morbidity. Ten of these 11 patients underwent 17 operations. Eight patients were cured t hrough medication, behavioral modification, intermittent catheterizati on, and/or other nonoperative treatments. The remaining 8 patients did not experience significant morbidity but did not have resolution of t heir symptoms as of their last medical evaluation, and most were lost to follow-up. Conclusions. Dysfunctional voiding resulted in severe mo rbidity in 11 (40%) of 27 study patients. Eight patients (30%) were cu red using nonoperative, conservative treatments, and 8 (30%) had unres olved symptoms within the follow-up period. Urodynamic studies are ess ential in the diagnosis of the syndrome but cannot be used to consiste ntly predict outcome. (C) 1997, Elsevier Science inc.