Continuous overnight monitoring of bladder activity in vesicoureteral reflux patients: II. Bladder activity types

Continuous overnight monitoring of the bladder activity was undertaken in children with vesicoureteral reflux. The investigation succeeded in 46 of 56 patients and showed bladder activity in all cases. Three types of bladder activity were revealed. One consisting of single contraction episodes exhibited periodicity with intervals of approximately 90 min. The second type consisted of a complex of contractions with increasing amplitude. They frequently lead to voiding. This type of activity seemed to be related to the bladder fullness. The third type of bladder activity consisted of vigorous repetitive contractions, most frequently found in the nonenuretic part of the material. The contractions in type III most frequently occurred with a frequency of 3–6/min. The degree of reflux was related to the type of bladder activity. Thus, the degree of reflex was significantly increased in patients with the second and third type of bladder activity when compared to patients with type I. The study shows that bladder activity takes place outside provocational episodes, e.g., cystometry and micturition, and seems to be closely related to the severity of reflux.