HOME BLADDER PRESSURE MONITORING IN CHILDREN WITH MYELOMENINGOCELE

Purpose: We evaluate a pressure gauge used at home for patients with m yelomeningocele on clean intermittent catheterization to provide a sys tem for inexpensive frequent monitoring of bladder pressures. Material s and Methods: Subjects with myelomeningocele using clean intermittent catheterization underwent cystometry in the laboratory. At home they obtained weekly volumes and bladder pressures before and after emptyin g. Home estimate of detrusor pressure was defined as full bladder pres sure minus empty bladder pressure. Medication changes, subject positio n and urinary tract symptoms were noted. Results: A total of 11 subjec ts 10.5 +/- 7.3 years old have been enrolled and have made 16.7 +/- 12 .6 weekly home bladder pressure and volume recordings in 4.7 +/- 3.1 m onths. Bladder capacities measured at home were 132 +/- 47% of cystome tric capacities. At volumes of data overlap home full pressures (31 +/ - 10 cm. water) were not statistically different from cystometric vesi cal pressures (25 +/- 9 cm. water). Home empty pressures (7 +/- 4 cm. water) were similar to cystometric abdominal pressures (14 +/- 8 cm. w ater). Home estimates of detrusor pressures (23 +/- 7 cm. water) magni fied differences in full and empty pressures, and were significantly g reater than cystometric detrusor pressures (11 +/- 11 cm. water). In 2 subjects significant increases in home full pressures occurred, which were associated with cessation of anticholinergic medication and infe ction. Conclusions: Home monitoring of bladder pressure is a simple, i nexpensive and accurate method of obtaining frequent bladder pressures in patients with myelomeningocele. These pressures are consistent ove r a large range of volumes and times, and could potentially be used to identify quickly changes in patient condition.