title: Voiding dysfunction in children: role of urodynamic studies.
abstract: BACKGROUND
  Urodynamic examination is said to be the most reliable, but also a rather invasive tool for the diagnosis of dysfunctional voiding in children. We compared the usefulness of baseline diagnostics to urodynamics.
  
  
  METHODS
  60 children, mean age 9 years, admitted for further evaluation of voiding dysfunctions (monosymptomatic nocturnal enuresis, 17; recurrent urinary tract infection, 12; reflux, 2; urgency, incontinence or residual urine, 29) underwent clinical examination, ultrasound, uroflowmetry, endoscopy and urodynamics.
  
  
  RESULTS
  Urodynamic evaluation revealed pathologic findings in 37 patients. Detrusor instability was found in 26 children, 11 children (18%) demonstrated signs of pelvic floor overactivity. Treatment decision was based on baseline diagnostics exclusively in 14 children, mainly on baseline diagnostics in 56 patients, and on urodynamics exclusively in 4 children (7%).
  
  
  CONCLUSIONS
  In children with idiopathic dysfunction, urodynamics did not have a significant additional value compared to baseline diagnostics. Therefore, noninvasive methods should be the first-line diagnostic tools. Only in patients with unsuccessful initial treatment should a urodynamic examination be performed to rule out severe bladder dysfunction.
authors.affiliation: Urologische Klinik, Ruhr-Universität Bochum, Marienhospital Herne, Herne, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Schewe
authors.forename: Frank H
authors.initials: FH
authors.lastname: Brands
authors.forename: Jürgen
authors.initials: J
authors.lastname: Pannek
mesh_terms: D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D014555:Urination Disorders / Q000175:diagnosis / Q000503:physiopathology*; D014563:Urodynamics