Urodynamic Studies in Boys with Disorders of the Lower Urinary Tract

Abstract

Sixteen boys with urethral strictures underwent urodynamic investigation pre- and postoperatively. The intravesical pressure preoperatively showed wide variations during micturition and was increased in only half of the patients. The urinary flow pre-operatively displayed a uniform picture with a decreased maximum flow in all the patients, plateau-formation and slow initiation of the flow curve. The maximum exit velocity of the urinary stream was decreased and the urethral energy losses were very high. After treatment, the out-flow situation was generally improved, but restored to normal only in some cases. Patients with short strictures showed the highest degree of urethral obstruction, but they also seemed to have the best prognosis, some of them even reaching supernormal flows. Flow measurement alone is recommended in the long-term follow-up, which is necessary in these patients. After-contraction was not present in any of the patients pre-operatively, but occurred in about half of them postoperatively. This and some other findings may indicate the existence of functional changes in the bladder neck in patients with urethral stricture. One case with partial detrusor muscle insufficiency is reported.