This article was originally published here

Neurouracil. December 9, 2021. doi: 10.1002/nau.24847. Online before printing.

Purpose: To describe a desktop urodynamic technique with ureteral occlusion (OUUO) and present a case series comparing the bladder volume in patients with severe vesicoureteral reflux (≥ IV VUR) with and without ureteral occlusion And pressure measurement to highlight clinical utility.

Methods: We performed OUUO on 7 patients who were considering surgical treatment of VUR and/or nephroureterectomy. We use hysterosalpingography catheter (HSG, single-lumen 5.5 Fr catheter with 1.5 ml balloon), guide wire and rigid cystoscope to seal the refluxing ureter. Then insert a 6 Fr dual lumen urodynamic (UD) catheter into the bladder to perform OUUO. Bladder volume and compliance (C = ∆bladder volume/∆detrusor pressure) are recorded and compared with the values ​​obtained under standard UD (no ureteral occlusion).

Results: The age range of the 7 patients was 2.0-15.5 years old. The general causes of VUR are posterior urethral valve (PUV) and neuropathy. The bladder capacity and compliance between the UD and OUUO results were found to be comparable in 5 patients. However, there are clinically significant differences in bladder capacity (20%-50% reduction) and compliance (50%-90%) between the UD and OUUO results in two-seventh of the patients.

Conclusion: In the presence of total VUR, OUUO can more accurately assess bladder capacity and compliance. OUUO should be considered when planning ureteral opening dilation/reimplantation and nephroureterectomy.