The after-contraction in paediatric urodynamics.
OBJECTIVE
To evaluate the incidence and significance of the urodynamic registration of an after-contraction in the bladder of children.


METHODS
In a prospective study, 250 children with a non-neurogenic voiding dysfunction (132 girls and 118 boys) were assessed for the occurrence of after-contractions during their video-urodynamic examination, and any filling-phase dysfunction noted. Twenty children in whom an after-contraction was recorded underwent additional voiding cystometry with three pressure transducers in the bladder (two microtip and one external transducer connected to a fluid-filled catheter).


RESULTS
Of the 250 children, an after-contraction was registered in 84 (63 girls and 21 boys). Eighty of these had a filling-phase dysfunction; 51 had detrusor instability, 16 a hypersensitive bladder, six a low and seven a high compliance. Only four showed a normal cystometric pattern during filling. In the 20 children who underwent further study, the after-contraction was confirmed as a detrusor contraction, as it was registered simultaneously on three transducers of two types in 10 children and on two microtip transducers in another 10 children.


CONCLUSIONS
The after-contraction is a frequent occurrence in children with voiding dysfunction, is related to bladder instability and is a genuine detrusor contraction.
Hoebeke
P B
PB
Department of Urology, University of Gent, Belgium.
Van Gool
J D
JD
Van Laecke
E
E
Vande Walle
J
J
Plancke
H
H
D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009119:Muscle Contraction / Q000502:physiology; D011312:Pressure; D011446:Prospective Studies; D001745:Urinary Bladder Diseases / Q000503:physiopathology*; D014555:Urination Disorders / Q000503:physiopathology*; D014563:Urodynamics