title: Influence of Urethral Sphincter Incompetence on Bladder Shape and Function in Myelodysplastic Children.
abstract: OBJECTIVE
  This study was undertaken to investigate the influence of the urethral function on bladder shape and function in myelodysplastic children.
  
  
  METHODS
  Of 39 myelodysplastic children, 30 were treated with intermittent catheterization. The diagnosis of internal sphincter incompetence (SI) was based on cystographic findings (open bladder neck) and that of external SI on urodynamic findings (underactive external sphincter identified on electromyography and maximum urethral closure pressure of less than 50 cm H2 O). Follow up included evaluation of bladder deformity and compliance.
  
  
  RESULTS
  The mean observation period was 8.6 years. In the 11 patients with external SI, bladder deformity and compliance significantly improved as a result of intermittent catheterization. However, of 12 patients with overactive sphincter and/or closure pressure of 50 cm H2 O or more, eight showed deterioration or no improvement in bladder deformity, and three showed upper urinary tract deterioration.
  
  
  CONCLUSIONS
  These results indicate that an increase in urethral resistance may lead to deterioration of bladder shape.
authors.affiliation: Department of Urology, Faculty of Medical Science, University of Fukui, Fukui, JapanDepartment of Integrative Cancer Therapy and Urology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Yokoyama
authors.affiliation: Department of Urology, Faculty of Medical Science, University of Fukui, Fukui, JapanDepartment of Integrative Cancer Therapy and Urology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Ito
authors.affiliation: Department of Urology, Faculty of Medical Science, University of Fukui, Fukui, JapanDepartment of Integrative Cancer Therapy and Urology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.
authors.forename: Mikio
authors.initials: M
authors.lastname: Namiki
keywords: bladder diseases; myelodysplastic syndromes; urethral sphincter; urinary catheterization