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Journal of Indian Association of Pediatric Surgeons
     Journal of Indian Association of Pediatric Surgeons
Official journal of the Indian Association of Pediatric Surgeons         
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 ORIGINAL ARTICLE
Year : 2007  |  Volume : 12  |  Issue : 2  |  Page : 72-75

Assessment of lower urinary tract function in children before and after Swenson's 'pull through' for Hirschsprung's disease


Department of Pediatric Surgery, All India Institute of Medical Science, New Delhi, India

Correspondence Address:
V Bhatnagar
Department of Pediatric Surgery, All India Institute of Medical Science, New Delhi - 110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9261.33225

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Aims: Long-term sequelae in children with Hirschsprung's disease (HD) are usually related to abnormalities in defecation. However, some of these patients also suffer from voiding dysfunction. The aim of this study is to assess and define the effects of Swenson's 'pull through' procedure in patients with HD on lower urinary tract function by means of urodynamic studies (UDS) performed before and after surgery. Materials and Methods: Six patients with Hirschsprung's disease underwent UDS before and after the definitive procedure. Parameters observed were maximum cystometric capacity, compliance, unstable detrusor contraction (UDCS), leak point pressure, residual volume, end filling pressure, volume at Pdet <20 cm H 2 O and volume at Pdet <30 cm H 2 O. Results: On UDS evaluation, one patient (16.6%) showed a small-capacity bladder and one patient (16.6%) showed a large-capacity bladder with occasional uninhibited detrusor contraction (UDCS) preoperatively. All the children had good compliant bladders. Postoperatively, one child was clinically symptomatic and showed hyporeflexic large-capacity bladder without any UDCS, one patient showed a small-capacity bladder with UDCS. Conclusions: In Hirschsprung's disease, neurovesical dysfunction may exist preoperatively and though the incidence of postoperative changes in neurovesical function may appear high, a larger study is required for statistical validation. Children who present with urinary problems after surgery should be assessed urodynamically.






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