Bladder Function in Children with Meningomyelocele: Comparison of Cine-Fluoroscopy and Urodynamics

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Abstract
Children (60) were assayed on an outpatient basis with cine-fluoroscopy combined with urodynamics. Bladder and rectal pressure together with sphincter electromyography (EMG) were measured during bladder filling under fluoroscopy, which was followed by measurement of rectal pressure and sphincter EMG during voiding under fluoroscopy. Comparison of the X-ray studies and urodynamics showed that the cystogram alone was not a reliable indicator of detrusor function. The sphincter electromyogram during voiding must be interpreted in the face of intra-abdominal pressure changes owing to straining or Crede''s maneuver. Residual urine estimations and the appearance of the bladder outflow on fluoroscopy were better parameters of outflow obstruction than sphincter electromyography.