title: The relevance of urodynamic studies for Urge syndrome and dysfunctional voiding: a multicenter controlled trial in children.
abstract: OBJECTIVE
  The objective of this study was to compare prospectively, in urge syndrome and dysfunctional voiding, clinical patterns with urodynamic patterns, to assess changes in urodynamic patterns after treatment, and to correlate urodynamic patterns and parameters with treatment outcome.
  
  
  METHODS
  In the European Bladder Dysfunction Study 97 children with clinically diagnosed urge syndrome received standard treatment, to which was randomly added placebo, oxybutynin or bladder training with online feedback. In a separate branch 105 children with clinically diagnosed dysfunctional voiding were randomly allocated to standard treatment or standard treatment plus pelvic floor training with online feedback. In all children urodynamic studies were performed before and immediately after treatment.
  
  
  RESULTS
  In urge syndrome detrusor overactivity was present in 33% of cases before and 27% after treatment (of which 65% were de novo). Detrusor overactivity did not correlate with treatment outcome. In dysfunctional voiding increased pelvic floor activity during voiding, which was present in 67% of cases before and 56% after treatment (of which 45% were de novo), did not correlate with treatment outcome. In urge syndrome as well as in dysfunctional voiding neither maximum detrusor pressure during voiding, cystometric bladder capacity, bladder compliance nor free flow patterns correlated with treatment outcome.
  
  
  CONCLUSIONS
  Neither detrusor overactivity nor increased pelvic floor activity during voiding correlated with treatment outcome. Standard treatment could be the first choice in urge syndrome as well as in dysfunctional voiding, reserving urodynamic studies for patients in whom this first approach fails.
authors: Department of Pediatrics, Antwerp University Hospital, Antwerp, Belgium. anbael@attglobal.net
authors: An
authors: A
authors: Bael
authors: Hildegard
authors: H
authors: Lax
authors: Tom P V M
authors: TP
authors: de Jong
authors: Piet
authors: P
authors: Hoebeke
authors: Rien J M
authors: RJ
authors: Nijman
authors: Rune
authors: R
authors: Sixt
authors: John
authors: J
authors: Verhulst
authors: Herbert
authors: H
authors: Hirche
authors: Jan D
authors: JD
authors: van Gool
mesh_terms: D000293:Adolescent; D000367:Age Factors; D016009:Chi-Square Distribution; D002648:Child; D004576:Electromyography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008333:Mandelic Acids / Q000627:therapeutic use*; D017773:Pelvic Floor / Q000503:physiopathology; D010808:Physical Examination; D026741:Physical Therapy Modalities; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000175:diagnosis* / Q000628:therapy*; D053202:Urinary Incontinence, Urge / Q000175:diagnosis* / Q000628:therapy*; D014563:Urodynamics
chemical_list: D008333:Mandelic Acids; C005419:oxybutynin