When should video and EMG be added to urodynamics in children with lower urinary tract dysfunction and is this justified by the evidence? ICI-RS 2014
Anding, Ralf; Smith, Phillip; de Jong, Tom; Constantinou, Christos; Cardozo, Linda; Rosier, Peter
(2016) Neurourology and Urodynamics, volume 35, issue 2, pp. 331 - 335
(Article)
Abstract
AIMS: An ICI-RS Think Tank in 2014 discussed and evaluated the evidence for adding video and EMG to urodynamics (UDS) in children and also highlighted evidence gaps, with the aim of recommending further clinical and research protocols. METHODS: A systematic analysis of the relevant literature for both X-ray (video) studies
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and electromyography, in combination with UDS in children with lower urinary tract dysfunction (LUTD), is summarized in this manuscript. The technical aspects are also critically reviewed. RESULTS: The body of evidence for the addition of X-ray (video) to filling and voiding cystometry and the evidence for the addition of pelvic muscle surface electromyography to urodynamics is scanty and insufficient. Standards are poor and variable so uncontrolled expert opinion dominates practice. CONCLUSIONS: The Think Tank has recommended that standardized ALARA ("As Low As Reasonably Achievable") principles should be adopted for video-urodynamics in children. The risk-benefit balance of X-ray exposure needs to be better evaluated and defined. Evaluation of images should be standardized and the association with pressure changes better analyzed and reported. Children's pelvic muscle surface electromyography technique should be standardized, technically improved, and its diagnostic relevance should be better evaluated.
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Keywords: Age Factors, Child, Diagnostic Techniques, Urological, Electromyography, Humans, Lower Urinary Tract Symptoms, Predictive Value of Tests, Prognosis, Reproducibility of Results, Urinary Bladder, Urodynamics, Video Recording, Consensus Development Conference, video-urodynamics, X-ray, EMG, Consensus Development Conference, Journal Article, Review
ISSN: 0733-2467
Publisher: Wiley-Liss Inc.
Note: © 2016 Wiley Periodicals, Inc.
(Peer reviewed)