title: Bladder compliance in myelodysplastic children: effect of anti-reflux surgery and conservative treatment. Paediatric urology.
abstract: Little is known about changes in bladder compliance and bladder capacity in myelodysplastic patients following anti-reflux surgery. A study group of 70 patients was divided as follows: group A included 20 myelodysplastic patients who had been operated on for reflux and whose subsequent treatment was conservative. Group B comprised 31 myelodysplastic patients who had been treated conservatively; a third group of 19 non-myelodysplastic patients, treated by anti-reflux surgery because of primary reflux, formed the control group. The follow-up period for group A averaged 61 months (extending from a urodynamic study 3 months after surgery to the most recent test). In group B the mean follow-up period between the initial test and the latest test was 86 months. Bladder compliance in group A patients did not increase significantly (from 5.5 to 6.9), but patients in group B did show a significant increase (from 5.9 to 10.7). Compliance in the 19 non-myelodysplastic patients decreased only marginally 6 months after surgery (from 29.6 to 26.3). Changes in bladder capacity showed a similar trend. In their most recent test, however, the bladder capacity of group A patients increased to the same volume as that of group B. A high correlation between radiological bladder deformity and bladder compliance was found. We propose a bladder compliance of 10.0 as the lower limit for myelodysplastic patients' preferred range. It was concluded that anti-reflux operations prevent any improvement in bladder compliance (but not in bladder capacity) compared with conservative treatment.
authors.affiliation: Department of Urology, Nagoya University School of Medicine, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Kondo
authors.forename: M
authors.initials: M
authors.lastname: Saito
authors.forename: K
authors.initials: K
authors.lastname: Kato
authors.forename: M
authors.initials: M
authors.lastname: Gotoh
authors.forename: M
authors.initials: M
authors.lastname: Narushima
authors.forename: Y
authors.initials: Y
authors.lastname: Itoh
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003187:Compliance; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009436:Neural Tube Defects / Q000503:physiopathology* / Q000601:surgery; D012189:Retrospective Studies; D001743:Urinary Bladder / Q000503:physiopathology*; D014563:Urodynamics; D014718:Vesico-Ureteral Reflux / Q000503:physiopathology / Q000601:surgery* / Q000628:therapy