URODYNAMIC PATTERN IN INFANTS WITH URINARY-TRACT INFECTION

Purpose: We studied the urodynamic pattern in infants with urinary tra ct infection and evaluated the influence of the infection. Materials a nd Methods: Cystometry was combined with voiding cystourethrography (v ideo cystometry) in 90 male and 68 female infants admitted to the hosp ital with first time urinary tract infection. Evaluation was performed 1 to 30 days (mean 11) and 32 to 78 days (mean 46) after diagnosis in 93 and 65 infants, respectively. Results: Bladder instability was fou nd in two-thirds of male and female infants. Compared to older childre n male infants had high voiding detrusor pressure and low bladder capa city (hypercontractility). Female infants also had increased voiding p ressure levels but they were significantly lower than those in male in fants. The voiding detrusor pressure was even higher in both sexes whe n evaluation was delayed after the infection. Conclusions: Infants wit h urinary tract infection have bladder instability and hypercontractil ity compared to older children. Bladder hypercontractility was less pr onounced early after infection, suggesting that the infectious agents inhibit detrusor muscle contractility. Whether hypercontractility is a normal urodynamic pattern in infancy or represents bladder dysfunctio n can only be addressed by urodynamic studies of healthy infants.