저빈도 배뇨증후군 환아에게 방광 내 전기자극치료

Abstract

Purpose: Intravesical electrical stimulation (IVES) has been performed at the Severance Hospital for various purposes in children with voiding difficulty due to neurogenic or non-neurogenic causes. The effect of IVES in children with infrequent voider syndrome is controversial. The aim of this study was to investigate the effect of IVES in children with infrequent voider syndrome. Materials and Methods: Between September 1999 and August 2001, 12 children diagnosed with infrequent voider syndrome, who received IVES at the Severance Hospital, were retrospectively analyzed. We investigated the changes in abdominal straining voiding, a voiding interval more than 8 hours, urgency and overflow incontinence after IVES. We also compared the uroflowmetry curve, maximal urine flow rate, maximal detrusor contraction pressure and residual urine volume after IVES. Results: Abdominal straining voiding, a voiding interval more than 8 hours, urgency and overflow incontinence were decreased from 83.3 to 25.0%, 50.0 to 16.7%, 25.0 to 0% and 58.3 to 25.0%, respectively. After IVES, fractionated voiding and flat-shape voiding were decreased from 66.7 to 16.7% and 33.3 to 8.3%, respectively. Whereas, bell-shape voiding was increased from 0 to 75.0%. The maximal urine flow rate was increased significantly, from 5.6 3.7 to 11.2 4.2m/s (p=0.002), but the residual urine volume was decreased significantly, from 71.7 47.5 to 9.2 13.8ml (p=0.0001). The maximal detrusor contraction pressure was increased in some children. Conclusions: The maximal urine flow rate was significantly increased after IVES in children with infrequent voider syndrome, but the residual urine volume was decreased significantly. There was a significant treatment effect in flat-voiding children, leading to the conclusion that IVES can be particularly effective in this specific group of children with infrequent voider syndrome.