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Çocuklarda Mesane Disfonksiyonunun Ultrasonografisi: Cinsiyet Ölçümler ve Tanıda Etkili mi?

Year 2019, Volume: 24 Issue: 2, 142 - 146, 13.06.2019

Abstract

Amaç: Çocuklarda mesane disfonksiyonunu ultrasonografi ile değerlendirmek
mümkün olmak­la birlikte, cinsiyet farkının mesane duvarı ölçümleri ve tanı üzerindeki
etkileri halen bilinmemek­tedir. Bu çalışmanın amacı, çocuklarda mesane
disfonksiyonu parametrelerini ultrasonografiyle ölçmek ve cinsiyetin tanı
performansına olası etkilerini belirlemektir.

Gereç ve Yöntemler: Çalışmaya mesane disfonksiyonu tanılı 64 çocuk (kız/erkek:
46/18; yaş: 7,8±2,5, 4–16 yıl) ve sağlıklı 11 (kız/erkek: 4/7; yaş: 9,9±4,4,
5–17 yıl) çocuk dahil edildi. Anteriyor, posteriyor ve her iki lateral mesane
detrusor duvarı işeme öncesi ve sonrası ölçüldü. Mesane boş ve dolu iken alınan
detrusor duvar kalınlık ölçüm oranları hesaplandı. Veriler istatistiksel olarak
analiz edildi; alıcı işlem karakteristik analizi yapıldı ve ölçümlerdeki
cinsiyete dayalı fark­lılıklar değerlendirildi.

Bulgular: Gruplar arası verilerin analizinde dolu/boş mesane detrusor
duvar kalınlık oranlarında sağlıklı ve hasta grup arasında anlamlı farklılıklar
saptanırken, cinsiyet ile ilişki izlenmedi. Dolu/ boş mesane detrusor kalınlığı
için eşik değerleri (sensitivite ve spesifite ile birlikte) anteriyor,
posteriyor, sağ lateral ve sol lateral detrusor için sırasıyla 0,321 (%75,
%63), 0,401(%70, %63), 0,328 (%73, %65), 0,321 (%75, %65) mm olarak bulundu.
Detrusor kalınlığı mesanenin dolu ya da boş olmasından bağımsız, her grup içinde
kız ve erkek cinsiyet arasında değişkenlik gösterdi. Aynı durum dolu/boş mesane
detrusor kalınlık oranları için de geçerliydi.







Tartışma ve Sonuç: Ultrasonografi ile
saptanan dolu/boş mesane detrusor kalınlık oranları, me­sane disfonksiyonu tanısına
cinsiyetten bağımsız olarak katkı sağlamaktadır.

References

  • References1. Chase J, Austin P, Hoebeke P, et al. The management of dysfunctional voiding in children: a report from the Standardisation Committee of the International Children's Continence Society. J Urol 2010;183:1296-302.2. Chen JJ, Mao W, Homayoon K, et al. A multivariate analysis of dysfunctional elimination syndrome, and its relationships with gender, urinary tract infection and vesicoureteral reflux in children. J Urol 2004;171:1907-10.3. Muller L, Abrahamsson K, Sillen U, et al. Ultrasound assessment of detrusor thickness in children and young adults with myelomeningocele. J Urol 2006;175:704-8.4. Colaco M, Dobkin RD, Sterling M, et al. The relationship between temperament, gender, and childhood dysfunctional voiding. Clin Pediatr (Phila) 2013;52:753-8.5. Akselim B, Doganay M, Ozcan N, et al. Correlation of bladder wall thickness and treatment success in types of urinary incontinence. Int Urogynecol J 2016;28:417-22.6. Tangal S, Gokce MI, Ozayar A, et al. Evaluation of a new ultrasound measurement tool for the diagnosis of dysfunctional voiding in pediatric population: full/empty bladder wall thickness ratio. Urology 2014;83:1369-72.7. Farhat W, Bagli DJ, Capolicchio G, et al. The dysfunctional voiding scoring system: quantitative standardization of dysfunctional voiding symptoms in children. J Urol 2000;164:1011-5.8. Muller L, Bergstrom T, Hellstrom M, et al. Standardized ultrasound method for assessing detrusor muscle thickness in children. J Urol 2000;164:134-8.9. Oelke M, Hofner K, Wiese B, et al. Increase in detrusor wall thickness indicates bladder outlet obstruction (BOO) in men. World J Urol 2002;19:443-52.10. Tanaka H, Matsuda M, Moriya K, et al. Ultrasonographic measurement of bladder wall thickness as a risk factor for upper urinary tract deterioration in children with myelodysplasia. J Urol 2008;180:312-6.11. Blatt AH, Titus J, Chan L. Ultrasound measurement of bladder wall thickness in the assessment of voiding dysfunction. J Urol 2008;179:2275-8; discussion 78-9.12. Serati M, Salvatore S, Cattoni E, et al. Ultrasound measurement of bladder wall thickness in different forms of detrusor overactivity. Int Urogynecol J 2010;21:1405-11.

Ultrasonography of Bladder Dysfunction in Children: Does Sex Affect the Measurements and Diagnosis?

Year 2019, Volume: 24 Issue: 2, 142 - 146, 13.06.2019

Abstract

Aim: Although evaluating bladder dysfunction in children with
ultrasonography is feasible, ef­fects of sex differences on the bladder wall
measurements and diagnosis are still unknown. This study aimed to measure
bladder dysfunction parameters in children by ultrasonography and determine the
possible effects of sex on the diagnostic performance.

Materials and Methods: The study included 64 children diagnosed with
bladder dysfunction (female/male: 46/18; age: 7.8±2.5, 4–16 years) and 11
healthy children (female/male: 7/4; age: 9.9±4.4, 4–17 years). The anterior,
posterior and both lateral walls of the bladder were measured using US before
and after urinating. The full-to-empty ratios (FER) of wall thickness were cal­culated.
Statistical data analysis and receiver operating characteristic analysis were
performed, and the measurements were evaluated for sex-based differences.

Results: Intergroup data analysis showed that the FER was consistently
different between the patients and healthy children, but not between the two
sexes. The FER cut-off thresholds (with sensitivity and specificity values) for
anterior, posterior, right lateral, and left lateral detrusor were 0.321 (75%,
73%), 0.401 (70%, 63%), 0.328 (73%, 65%), and 0.321 (75%, 65%) mm, respec­tively.
The detrusor thicknesses varied between females and males within each group
irrespec­tive of whether the bladder was full or empty. The same was also true
for the FER.







Discussion and Conclusion: Ultrasound-based
FER measurement of bladder wall thickness is significantly useful in the
diagnosis of bladder dysfunction, irrespective of sex.

References

  • References1. Chase J, Austin P, Hoebeke P, et al. The management of dysfunctional voiding in children: a report from the Standardisation Committee of the International Children's Continence Society. J Urol 2010;183:1296-302.2. Chen JJ, Mao W, Homayoon K, et al. A multivariate analysis of dysfunctional elimination syndrome, and its relationships with gender, urinary tract infection and vesicoureteral reflux in children. J Urol 2004;171:1907-10.3. Muller L, Abrahamsson K, Sillen U, et al. Ultrasound assessment of detrusor thickness in children and young adults with myelomeningocele. J Urol 2006;175:704-8.4. Colaco M, Dobkin RD, Sterling M, et al. The relationship between temperament, gender, and childhood dysfunctional voiding. Clin Pediatr (Phila) 2013;52:753-8.5. Akselim B, Doganay M, Ozcan N, et al. Correlation of bladder wall thickness and treatment success in types of urinary incontinence. Int Urogynecol J 2016;28:417-22.6. Tangal S, Gokce MI, Ozayar A, et al. Evaluation of a new ultrasound measurement tool for the diagnosis of dysfunctional voiding in pediatric population: full/empty bladder wall thickness ratio. Urology 2014;83:1369-72.7. Farhat W, Bagli DJ, Capolicchio G, et al. The dysfunctional voiding scoring system: quantitative standardization of dysfunctional voiding symptoms in children. J Urol 2000;164:1011-5.8. Muller L, Bergstrom T, Hellstrom M, et al. Standardized ultrasound method for assessing detrusor muscle thickness in children. J Urol 2000;164:134-8.9. Oelke M, Hofner K, Wiese B, et al. Increase in detrusor wall thickness indicates bladder outlet obstruction (BOO) in men. World J Urol 2002;19:443-52.10. Tanaka H, Matsuda M, Moriya K, et al. Ultrasonographic measurement of bladder wall thickness as a risk factor for upper urinary tract deterioration in children with myelodysplasia. J Urol 2008;180:312-6.11. Blatt AH, Titus J, Chan L. Ultrasound measurement of bladder wall thickness in the assessment of voiding dysfunction. J Urol 2008;179:2275-8; discussion 78-9.12. Serati M, Salvatore S, Cattoni E, et al. Ultrasound measurement of bladder wall thickness in different forms of detrusor overactivity. Int Urogynecol J 2010;21:1405-11.
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Details

Primary Language English
Subjects Health Care Administration
Journal Section ORIGINAL ARTICLE
Authors

Yasemin Durum Polat 0000-0002-4452-6632

Gizem Esen This is me

Ferah Sönmez This is me 0000-0003-3027-5032

Filiz Abacıgil 0000-0003-3027-5032

Mehmet Bilgen This is me 0000-0001-5671-2021

Publication Date June 13, 2019
Acceptance Date December 28, 2018
Published in Issue Year 2019 Volume: 24 Issue: 2

Cite

Vancouver Durum Polat Y, Esen G, Sönmez F, Abacıgil F, Bilgen M. Ultrasonography of Bladder Dysfunction in Children: Does Sex Affect the Measurements and Diagnosis?. Anatolian Clin. 2019;24(2):142-6.

13151 This Journal licensed under a CC BY-NC (Creative Commons Attribution-NonCommercial 4.0) International License.