NATURAL FILLING CYSTOMETRY IN INFANTS AND CHILDREN

Objective To evaluate natural filling cystometry in infants and young children. Patients and methods The study group comprised 37 infants an d young children (mean age, 4.1 years) with various urological conditi ons. Suprapubic catheters were used in all patients with urethral sens ation. Natural filling urodynamic (NFU) studies were performed using a n ambulatory recorder and with an observer present throughout. For com parison, 17 of the 37 patients also had slow filling conventional cyst ometry (CMG). Results All NFU studies were successfully completed and the great majority of patients were unaffected by the investigation pr ocedures. In comparison with conventional cystometry there were signif icant differences. For NFU, there was a lower bladder capacity (means, NFU 122 mL vs CMG 188 mL, P < 0.03); lower pressure rise on filling ( means, NFU 5.7 cmH(2)O vs CMG 16.1 cmH(2)O, P < 0.001) and higher maxi mum detrusor pressures during micturition (means, NFU 130 cmH(2)O vs C MG 78 cmH(2)O, P < 0.01). Voiding efficiency was also slightly greater with NFU compared with CMG. Detrusor instability was recorded in five patients only during NFU and in two other patients only during CMG. C onclusion A natural filling cystometry method which incorporates an un obtrusive recording system is likely to be superior to conventional CM G for assessing bladder function in infants and children. This is beca use (i) bladder function is investigated in near to natural conditions , (ii) the patients are mostly unaffected by the investigation procedu res, (iii) there are significant differences between NFU and CMG in th e measurements obtained, indicating that CMG may give false indices of bladder function.