Bladder Compliance in Myelodysplastic Children: Effect of Anti‐reflux Surgery and Conservative Treatment

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Abstract
Summary— Little is known about changes in bladder compliance and bladder capacity in myelodysplastic patients following anti‐reflux surgery. A study group of 70 patients was divided as follows: group A included 20 myelodysplastic patients who had been operated on for reflux and whose subsequent treatment was conservative. Group B comprised 31 myelodysplastic patients who had been treated conservatively; a third group of 19 non‐myelodysplastic patients, treated by anti‐reflux surgery because of primary reflux, formed the control group. The follow‐up period for group A averaged 61 months (extending from a urodynamic study 3 months after surgery to the most recent test). In group B the mean follow‐up period between the initial test and the latest test was 86 months.Bladder compliance in group A patients did not increase significantly (from 5.5 to 6.9), but patients in group B did show a significant increase (from 5.9 to 10.7). Compliance in the 19 non‐myelodysplastic patients decreased only marginally 6 months after surgery (from 29.6 to 26.3). Changes in bladder capacity showed a similar trend. In their most recent test, however, the bladder capacity of group A patients increased to the same volume as that of group B. A high correlation between radiological bladder deformity and bladder compliance was found. We propose a bladder compliance of 10.0 as the lower limit for myelodysplastic patients' preferred range.It was concluded that anti‐reflux operations prevent any improvement in bladder compliance (but not in bladder capacity) compared with conservative treatment.