title: Evaluation of bladder instability in children with recurrent urinary tract infections.
abstract: BACKGROUND
  Impairment in the functions of the lower urinary tract can be the cause of recurrent urinary tract infections (UTI) and vesicoureteral reflux (VUR) in children. The purpose of our research was to evaluate the frequency of occurrence of bladder instability in children with UTI.
  
  
  METHODS
  The research involved 114 children (21 boys, 93 girls), ranging in age from 5 to 16. Group I consisted of 61 children with a history of recurrent UTI, while Group II included 53 children with recurrent UTI and VUR. Urodynamic tests (uroflowmetry and cystometry) were done on all the children, while in selected cases profilometry was also performed, using a Duet apparatus (Dantec Medical A/S).
  
  
  RESULTS
  Abnormal functioning of the lower urinary tract was found in 45 children (74%) from Group I and 44 children (84%) from Group II. The most common dysfunction was instability of the detrusor muscle, which was found in 52 children (45%), including 23 (38%) from Group I and 29 (55%) from Group II. In 19 children detrusor instability was accompanied by reduced bladder volume, and in 8 cases there was a lack of detrusor-sphincter coordination. In both groups ca. 20% of the children did not present with symptoms indicating urination dysfunctions. Ca. 80% reported various symptoms, of which the most common were nocturnal wetting and urinary urgency. In half of the children from Group I and one-fourth of the children from Group II there were several co-occurring symptoms: nocturnal and diurnal wetting, pollakiruria, and urinary urgency, or all three symptoms simultaneously.
  
  
  CONCLUSIONS
  The most common disturbance of lower urinary tract functioning in these children with recurrent UTI was instability of the detrusor muscle, which occurred more often in children with VUR.
authors.affiliation: 1st Department of Pediatrics Diseases, Medical University of Białystok, Poland.
authors.forename: Wiesława
authors.initials: W
authors.lastname: Winiecka
authors.forename: Walentyna
authors.initials: W
authors.lastname: Zoch-Zwierz
authors.forename: Anna
authors.initials: A
authors.lastname: Wasilewska
authors.forename: Ryszard
authors.initials: R
authors.lastname: Wierciński
authors.forename: Barbara
authors.initials: B
authors.lastname: Tomaszewska
authors.forename: Agata
authors.initials: A
authors.lastname: Korzeniecka-Kozerska
authors.forename: Tadeusz
authors.initials: T
authors.lastname: Porowski
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D012008:Recurrence; D001745:Urinary Bladder Diseases / Q000150:complications*; D014552:Urinary Tract Infections / Q000150:complications*; D014563:Urodynamics; D014718:Vesico-Ureteral Reflux