A study from New Delhi, India tried to correlate urodynamic studies with findings that you could actually see on voiding patterns, neurological status, and radiological findings. Mishra, et al [1] used 30 consecutive children with spina bifida who underwent clinical evaluation, urinary tract imaging, and cystometrogram.

Cystometry was abnormal in 87 per cent with overactive detrusor in 77 per cent. Seventeen patients (57 per cent) had significant post void residual urine. Radiological findings were abnormal in 53 per cent however, 90 per cent of these patients had detrusor hyperactivity while ten per cent had an under-active detrusor. Thirteen patients had insignificant post void residual urine. Of these 13 patients, six (46 per cent) had abnormalities on cystometry. The seven patients in this group with insignificant post void residuals had normal upper urinary tracts. Only four of them had evidence of abnormalities on cystometrogram.

The study concluded that patients with significant post void residual urine can be presumed to have detrusor hyperactivity and may be initially managed with clean intermittent catheterization and medical bladder management. Cystometrograms are indicated if the upper urinary tract shows deterioration. This study also found that in patients with insignificant post void residuals and abnormal clinical evaluation or radiographic studies detrusor hyperactivity can be presumed and urodynamic studies can be typically deferred. Patients with insignificant post void residual and normal bladder radiology but abnormal clinical findings must undergo initial urodynamic studies.


[1] Journal of Pediatric Urology. 3(3):195-199, June 2007.
doi:10.1016/j.jpurol.2006.07.009

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