Biomedical subjects

M Bachelard

Publications and source records attributed to M Bachelard.

5 recordsLinked to original sources

PubMed1999

Urodynamic pattern in asymptomatic infants: siblings of children with vesicoureteral reflux.

PURPOSE: We studied the urodynamic pattern in asymptomatic infants who are siblings of children with vesicoureteral reflux. MATERIALS AND METHODS: Cystometry and perineal electromyography were performed with voiding cystourethrography in 16 male and 21 female infant siblings screened for reflux at age 0.2 to 7.3 months (median 1.1). RESULTS: Vesicoureteral reflux was present in 25% of the male and 10% of the female infants. In those without vesicoureteral reflux unstable bladder contractions were noted in 8% of the male and 16% of the female subjects. In these infants median maximum voiding detrusor pressure was 127 (range 84 to 211) and 72 cm. water (range 42 to 240), respectively, and median bladder capacity was 20 ml. (range 10 to 49 and 10 to 120, respectively). Maximum voiding detrusor pressure was significantly higher in male than in female infants (p <0.01). Perineal electromyography was interpretable in 13 of the 16 male and 16 of the 21 female infants overall. All but 1 female subject had increased activity during voiding, which was also present intermittently in all subjects. CONCLUSIONS: Our study of asymptomatic siblings of children with vesicoureteral reflux has provided results that may be used as reference data for normal urodynamics in early infancy. Instability was rare. Bladder capacity was lower than expected with a predicted capacity at birth of approximately 20 ml. Maximum voiding pressure was high, especially in male subjects. The urodynamic voiding pattern suggests physiological dyscoordination, probably due to immature detrusor-sphincter function.

Female↗

PubMed1998

Urodynamic pattern in infants with urinary tract infection.

PURPOSE: We studied the urodynamic pattern in infants with urinary tract infection and evaluated the influence of the infection. MATERIALS AND METHODS: Cystometry was combined with voiding cystourethrography (video cystometry) in 90 male and 68 female infants admitted to the hospital 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 found in two-thirds of male and female infants. Compared to older children male infants had high voiding detrusor pressure and low bladder capacity (hypercontractility). Female infants also had increased voiding pressure levels but they were significantly lower than those in male infants. The voiding detrusor pressure was even higher in both sexes when evaluation was delayed after the infection. CONCLUSIONS: Infants with urinary tract infection have bladder instability and hypercontractility compared to older children. Bladder hypercontractility was less pronounced early after infection, suggesting that the infectious agents inhibit detrusor muscle contractility. Whether hypercontractility is a normal urodynamic pattern in infancy or represents bladder dysfunction can only be addressed by urodynamic studies of healthy infants.

Bacteriuria↗

PubMed1996

Gross bilateral reflux in infants: gradual decrease of initial detrusor hypercontractility.

PURPOSE: We performed followup investigations of the urodynamic patterns of 11 boys with gross bilateral reflux, which are sometimes characterized by low bladder capacity and hypercontractility of the detrusor. MATERIALS AND METHODS: Urodynamic evaluations were done a mean of 2 years after the initial assessment during infancy. RESULTS: Initial hypercontractility resolved and bladder capacity increased from below normal to high in the majority of cases. The number of children with instability did not change significantly. CONCLUSIONS: The urodynamic pattern at followup was similar to that previously reported as the most common dysfunction in older children with reflux.

Follow-Up Studies↗

PubMed1996

Video cystometric recording of dilating reflux in infancy.

PURPOSE: Bladder hypercontractility has previously been suggested to occur in male infants with gross bilateral reflux, and the causal relationship between hypercontractility and reflux has been questioned. MATERIALS AND METHODS: In this video urodynamic study of dilating reflux the association between reflux and bladder pressure was evaluated in 16 infants. RESULTS: In our 11 male patients hypercontractility was noted often, usually with reflux that occurred simultaneously with an increase in detrusor pressure. In the 5 female patients no hypercontractility was noted and reflux occurred without an increase in detrusor pressure. CONCLUSIONS: Our results further confirm the association between bladder dysfunction and dilating reflux in infants but with different patterns in male and female infants.

Female↗

PubMed1995

The changing urodynamic pattern in valve bladders during infancy.

Bladder dysfunction in boys with posterior urethral valves is well documented in studies of long-term followup. These reports suggest that dysfunctional bladders can be divided into 3 main types, including unstable, low compliant and over distended. To our knowledge urodynamic findings at presentation during infancy have not been described previously. We report on 16 male patients born between 1989 and 1993 who presented with symptoms of posterior urethral valves between birth and age 5 months, and who were followed with repeated urodynamic evaluations for a mean of 19 months. At presentation the bladder was hypercontractile with low capacity. During the first 3 years of life, the urodynamic pattern changed with vanishing hypercontractility and increasing bladder capacity, although instability remained unchanged with emptying difficulties. Thus, the 3 patterns of bladder dysfunction reported in older boys after resection of posterior urethral valves could not be found in infants and small children.

Humans↗