title: Feasibility of urodynamic study (combined cystometry and electromyography of the external urethral sphincter) under general anesthesia in children.
abstract: BACKGROUND
  To assess the feasibility of urodynamic study under general anesthesia (GA) we performed electromyography of the external urethral sphincter (EUS-EMG) on 73 children and cystometry (CM) alone on 10 children.
  
  
  METHODS
  Subjects were divided into 3 groups. Those in groups I and II were suspected of having voiding dysfunction with (group I) or without (group II) overt neurospinal defects, while those in group III were thought to be functionally normal. EUS-EMG was performed under light anesthesia following cystourethroscopy to examine structural abnormalities. Atropine sulfate premedication was not used for the anesthetic procedure; muscle relaxants were used only for tracheal intubation.
  
  
  RESULTS
  Voiding was observed in 83% of the patients. Among patients who voided, detrusor-external sphincter dyssynergia (DSD) was noted in 7 (38%) group I patients and 6 (19%) group II patients; in group III, voiding was synergic in all patients. In 10 cases, CM alone was carried out both under anesthesia and in the waking state; anesthesia suppressed detrusor hyperreflexia (DH) in all 9 patients but produced no change in bladder compliance.
  
  
  CONCLUSIONS
  In children with urinary disorders, urodynamic study under GA following cystourethroscopy is a feasible method for assessing EUS function and documenting DSD; DH is not evaluable, however. Stratifying urinary management on the basis of these examinations resulted in satisfactory clinical outcomes.
authors.affiliation: Department of Urology, Hokkaido University School of Medicine, Sapporo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Ameda
authors.forename: H
authors.initials: H
authors.lastname: Kakizaki
authors.forename: T
authors.initials: T
authors.lastname: Yamashita
authors.forename: K
authors.initials: K
authors.lastname: Nonomura
authors.forename: Y
authors.initials: Y
authors.lastname: Shinno
authors.forename: O
authors.initials: O
authors.lastname: Kemmotsu
authors.forename: T
authors.initials: T
authors.lastname: Koyanagi
mesh_terms: D000293:Adolescent; D000768:Anesthesia, General; D002648:Child; D002675:Child, Preschool; D003558:Cystoscopy; D004576:Electromyography; D004724:Endoscopy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012016:Reference Values; D012018:Reflex; D014521:Urethra / Q000473:pathology / Q000502:physiology* / Q000503:physiopathology; D001743:Urinary Bladder / Q000473:pathology; D014554:Urination; D014555:Urination Disorders / Q000503:physiopathology; D014563:Urodynamics; D014851:Wakefulness