Peer-reviewed article
Contrast-enhanced voiding urosonography - urodynamics in patients with neurogenic bladder dysfunction: a pilot study within pediatric urological practice
Alexandra Wilke, Tina Hörz, Monica Pleul, Carola Hörz, Katrin Schuchardt et al. ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This pilot study looked at whether a radiation-free ultrasound test with contrast (ceVUS) can be done at the same time as routine bladder pressure testing (urodynamics) in children with neurogenic bladder dysfunction. Nineteen patients, with an average age of 11.4 years, were examined from January 2025. The combined test was done safely and did not interfere with the urological measurements. It found previously unknown secondary vesicoureteral reflux in six children, and treatment was changed for five of them. The authors say it is feasible and safe, but that further studies are needed to show whether it can replace video urodynamics or improve long-term kidney outcomes.
Key points
- 19 children with neurogenic bladder dysfunction (average age 11.4 years; 9 male, 10 female) had ceVUS during urodynamic follow-up.
- The combined ceVUS-UD test was performed safely and did not interfere with the urological measurements.
- Previously unknown secondary vesicoureteral reflux was found in 6 patients (31.6%).
- In one case, bladder pressure dropped markedly when reflux occurred.
- Treatment was changed for 5 children after the findings.
Limitations
This is a small pilot study of 19 children, apparently from a single practice, with no comparison group and no long-term follow-up. It cannot show whether ceVUS-UD can replace video urodynamics or whether routine reflux monitoring improves kidney outcomes.
Abstract
Background The progressive loss of kidney function is a major cause of morbidity and mortality in children with neurogenic bladder dysfunction. A consequent follow-up, including repeated urodynamics combined with detection of vesicoureteral reflux (VUR) is crucial for the individual treatment of the urinary tract. The aim of our study is to investigate whether contrast-enhanced voiding urosonography -urodynamics (ceVUS-UD) can be used in routine urological diagnostics. Due to its radiation-free nature in a more comfortable environment, this would allow the examination to be performed frequently enabling more accurate monitoring of bladder function. Methods Since January 2025, 19 patients with neurogenic bladder dysfunction have undergone simultaneous ceVUS as part of urodynamic follow-up. The children were 11.4 years old on average (9 male, 10 female) and showed one of the following underlying conditions: spina bifida, detrusor hyperactivity after spinal cord injury, caudal regression syndrome, epispadias, infantile cerebral palsy or myotonic dystrophy type 1. Two-thirds of the patients performed self-intermittent catheterization. Results CeVUS-UD can be safely performed as part of routine urodynamic testing without interfering with urological measurements. Previously unknown secondary VUR (sVUR) was detected in six patients (31.6%). In one case, a significant decrease of vesical pressure during the occurrence of reflux was observed. For five children, this led to a change in treatment . Conclusions In this study, CeVUS-UD provides a feasible, safe and radiation-free tool for characterizing neurogenic bladder dysfunction. Whether ceVUS-UD can serve as an alternative to video urodynamics (VUD), and whether routine monitoring of sVUR translates into improved long-term kidney outcomes, remains to be established in further studies.