Tower Bladder: A Silent Threat in Pediatric Neurogenic Bladder – An Evaluation of Clinical Outcomes Based on Radiological and Urodynamic Markers

Tower Bladder: A Silent Threat in Pediatric Neurogenic Bladder – An Evaluation of Clinical Outcomes Based on Radiological and Urodynamic Markers | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Tower Bladder: A Silent Threat in Pediatric Neurogenic Bladder – An Evaluation of Clinical Outcomes Based on Radiological and Urodynamic Markers DERYA YAYLA, Güneş Işık This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6895753/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective: This study aimed to assess the prognostic significance of “tower bladder” morphology in pediatric patients with neurogenic bladder, focusing on its association with radiological and urodynamic indicators and its predictive value for renal impairment. Materials and Methods: We retrospectively reviewed 164 children (mean age: 7.7 ± 4.6 years) with neurogenic bladder managed at Gaziantep City Hospital between October 2023 and May 2024. Evaluations included voiding cystourethrography (VCUG) for bladder morphology and bladder diameter ratio (BDR), vesicoureteral reflux (VUR) grading, and dimercaptosuccinic acid (DMSA) scintigraphy for renal scarring. Urodynamic parameters, age-adjusted serum creatinine, timing of clean intermittent catheterization (CIC), and anticholinergic therapy duration were recorded. Results: Tower bladder morphology was observed in 71.3% of patients and was significantly associated with higher intravesical pressure (46.2 ± 24.2 vs. 26.7 ± 19.1 cmH₂O; p < 0.001), elevated BDR (p < 0.001), high-grade VUR (p = 0.006), and increased renal scarring (p = 0.020). Late CIC initiation was linked to tower bladder (p = 0.019). Although anticholinergic therapy reduced pressure (p < 0.001), it had limited effect on renal preservation. Conclusion: Tower bladder is a morphological marker of poor prognosis in pediatric neurogenic bladder, correlating with high intravesical pressure and renal risk. Early CIC and pharmacotherapy are essential to prevent irreversible damage. Integration of radiologic and functional data is critical for individualized risk assessment and management planning. Neurogenic bladder tower bladder intravesical pressure DMSA vesicoureteral reflux creatinine Figures Figure 1 Figure 2 Introduction Neurogenic bladder is a severe functional disorder of the lower urinary tract resulting from congenital or acquired neurological pathologies that impair the neural control of bladder storage and voiding. In pediatric populations, the most common etiological factors include congenital spinal dysraphism syndromes, particularly myelomeningocele. In these patients, bladder dysfunction typically begins at birth and progresses with urological and nephrological complications. If left untreated, it may lead to irreversible pathologies such as VUR, hydronephrosis, renal cortical scarring, hypertension, and chronic renal disease [1,2]. In regions where neural tube defects are prevalent, the importance of prenatal screening and folic acid prophylaxis has been increasingly emphasized [3]. The pathophysiology of neurogenic bladder involves significant urodynamic abnormalities such as detrusor-sphincter dyssynergia, decreased bladder compliance, detrusor overactivity, and elevated intravesical pressure. Notably, intravesical pressures exceeding 40 cmH₂O are considered a major predictor of upper urinary tract damage. Therefore, early identification and control of bladder pressures in high-risk pediatric patients is crucial for long-term preservation of renal function [4,5]. In recent years, specific morphologic patterns identified via radiological imaging-particularly on VCUG-have been shown to reflect underlying functional abnormalities. One such pattern is the so-called “tower bladder,” characterized by pronounced vertical elongation of the bladder dome, a narrowed base, and typically associated with high-pressure voiding. Although the clinical significance of this morphological feature remains under investigation, there is growing evidence suggesting its association with elevated intravesical pressure, the presence of VUR, and renal scarring. The presence of tower bladder may not merely represent an anatomical variation, but rather indicate a high-risk bladder dysfunction phenotype. To objectively assess this structural abnormality, the BDR, defined as the ratio of vertical to horizontal dimensions on VCUG, has emerged as a quantifiable morphological marker. Failure to establish an early diagnosis or delay in initiating appropriate management in these patients may result in irreversible renal damage. Early initiation of CIC and anticholinergic pharmacotherapy plays a key role in reducing intravesical pressure and preventing upper urinary tract complications [6,7]. This study aims to elucidate the prognostic value of tower bladder morphology in children with neurogenic bladder, and to investigate its relationship with radiological and urodynamic indicators. Furthermore, by analyzing the impact of conservative treatment timing on both morphological and functional parameters, we aim to provide clinical guidance for individualized management strategies Materials and Methods This retrospective, cross-sectional study included 164 pediatric patients (50.6% female, 49.4% male; mean age: 7.7 ± 4.6 years) diagnosed with neurogenic bladder and managed at Gaziantep City Hospital between October 2023 and May 2024. The etiologies of neurogenic bladder were as follows: • Operated myelomeningocele with associated spinal pathology: 32 patients (61.6%) • Isolated spinal pathology: 18 patients (19.5%), including spina bifida (n=14), operated spinal tumors (n=4), and spinal trauma (n=1) • Detrusor overactivity-related causes: Isolated VUR: 18 patients (11.0%), detrusor-sphincter dyssynergia (DSD): 7 patients (4.3%), operated anorectal malformation: 3 patients (1.8%), operated posterior urethral valve: 3 patients (1.8%) Sociodemographic variables—including age, sex, nationality, maternal age at delivery, and maternal folic acid supplementation during pregnancy—were recorded following approval from the institutional ethics committee (Ethics Approval No: 2024/40). Walking status was also documented as a surrogate marker of neurologic impairment severity. Pediatric age-specific reference ranges for serum creatinine levels were interpreted in accordance with the Nelson Textbook of Pediatrics to account for developmental renal function variation (3). Radiological Assessment: Imaging modalities included US, VCUG, and nuclear scintigraphy (DMSA and, when applicable, DTPA scans). US was used to evaluate bladder wall thickness, ureteral dilatation, and post-void residual (PVR) urine volume. VCUG was utilized to assess bladder morphology and grade VUR. The BDR was calculated as the vertical-to-horizontal dimension ratio (Figure I). Tower bladder morphology was defined as the presence of vertical elongation of the bladder dome on VCUG in conjunction with a BDR >1. DMSA scintigraphy was used to quantify renal cortical damage, and obstructive patterns were recorded on DTPA scans when performed. Urodynamic Assessment: Urodynamic studies included evaluations of bladder capacity, intravesical pressure, bladder compliance, and the volume at which intravesical pressure reached 40 cmH₂O. In addition, the following treatment-related variables were documented: age at initiation and duration of CIC, type and duration of anticholinergic therapy, administration of intradetrusor botulinum toxin, performance of vesicostomy, and bladder augmentation procedures. Therapeutic Interventions: The management strategies implemented in these patients included; CIC: Performed in 124 patients (75.6%), with a mean initiation age of 5.2 ± 4.7 years and a mean duration of 22.6 ± 31.7 months Pharmacologic therapy: Oral anticholinergics: oxybutynin (40.2%), propiverine (10.4%), and tolterodine (9.8%) Intradetrusor botulinum toxin injections: 39 patients (23.8%) Subureteric injection for VUR management: 22 patients (13.4%) Vesicostomy: 3 patients (1.8%) Bladder augmentation: 3 patients (1.8%) (Table I) Statistical Analysis: All statistical analyses were conducted using IBM SPSS Statistics version 26.0. Continuous variables were expressed as mean ± standard deviation (SD), and categorical variables as frequencies and percentages. The Kolmogorov–Smirnov test was employed to assess data distribution normality. Between-group comparisons were performed using the independent samples t-test, ANOVA, and chi-square test. Post hoc analyses (Bonferroni or Tukey) were applied where appropriate. Correlations between continuous variables were analyzed using Pearson’s correlation coefficient. A p-value of <0.05 was considered statistically significant. Results 1. Findings Related to Intravesical Pressure (Table II) Among the 164 pediatric patients with neurogenic bladder included in the study, tower bladder morphology was identified in 71.3% of cases. This subgroup exhibited significantly higher mean intravesical pressure values (46.2 ± 24.2 cmH₂O vs. 26.7 ± 19.1 cmH₂O; p < 0.001), greater BDR (1.439 ± 0.29 vs. 1.321 ± 0.28; p = 0.008), and a markedly higher incidence of high-grade VUR (Grades IV–V: 58.8% vs. 10.6%; p = 0.006) compared to those without tower bladder. Moreover, patients with tower bladder began CIC at significantly older ages (5.7 ± 4.7 years vs. 3.4 ± 4.4 years; p = 0.019). A positive correlation was observed between CIC duration and intravesical pressure (r = 0.302; p < 0.001). Intravesical pressure was positively correlated with BDR (r = 0.362; p < 0.001), serum creatinine level (r = 0.168; p = 0.031), post-void residual volume (PVR) (r = 0.201; p = 0.024), and duration of anticholinergic therapy (r = 0.286; p < 0.001). Patients with renal scarring on DMSA scintigraphy demonstrated significantly higher intravesical pressure values (44.2 ± 24.3 cmH₂O vs. 35.0 ± 23.7 cmH₂O; p = 0.020). Children with serum creatinine levels exceeding twice the age-adjusted normal range exhibited significantly higher intravesical pressures compared to those with normal values (p = 0.015). Similarly, patients receiving anticholinergic therapy demonstrated significantly increased intravesical pressures relative to untreated counterparts (p 0.05). 2. Findings Related to BDR (Table III) A statistically significant difference in BDR values was observed depending on the bladder volume at which the intravesical pressure reached 40 cmH₂O (p < 0.001). Post hoc analysis revealed that patients who reached the threshold pressure at one-half or one-quarter of expected bladder capacity exhibited significantly higher BDR values compared to those who did not reach this threshold (both p < 0.001). A moderate positive correlation was identified between BDR and intravesical pressure (r = 0.362; p < 0.001). No correlation was found between BDR and bladder capacity. In the overall cohort, a weak-to-moderate positive correlation was observed between BDR and intravesical pressure (r = 0.362; p < 0.001), whereas in the subgroup of patients with tower bladder, the correlation remained positive but was weaker (r = 0.184; p = 0.048). BDR values were significantly higher in patients with obstructive patterns on DTPA scans (p = 0.001) and in those who were non-walking (p = 0.008). Furthermore, children whose serum creatinine values were more than twice the age-specific normal range exhibited the highest BDR values (p = 0.014). To assess the diagnostic utility of BDR in predicting renal scarring, a receiver operating characteristic (ROC) analysis was conducted. The area under the ROC curve (AUC) indicated high discriminative power, and a BDR cutoff value of >1.4 was identified as highly sensitive and specific for the prediction of renal damage (Figure II). 3. Findings Related to Tower Bladder Among patients with tower bladder morphology, a significantly higher proportion reached an intravesical pressure of 40 cmH₂O at early bladder filling volumes (p < 0.001). Additionally, the presence of tower bladder was significantly associated with delayed initiation of CIC (p = 0.019) (Table IV). Patients who reached the threshold pressure of 40 cmH₂O at earlier stages of bladder filling demonstrated significantly elevated BDR values (p < 0.001), suggesting a parallel progression of morphological distortion and functional deterioration. A significant positive association was observed between the duration of CIC and intravesical pressure (p < 0.001), indicating that prolonged catheterization was linked to higher bladder pressures. Moreover, the timing of CIC initiation was significantly associated with the degree of bladder fullness at which pressure elevation occurred (p = 0.020) (Table V) . These findings further support the hypothesis that both delayed intervention and impaired bladder compliance contribute to the development and progression of tower bladder morphology. 4. Outcomes Related to Therapeutic Interventions Among the 74 patients who received anticholinergic therapy, no statistically significant association was found between changes in intravesical pressure and clinical improvement (p > 0.05). A reduction in intravesical pressure was observed in 44.6% of these patients, while an increase was recorded in 21.6%. There was no statistically significant difference in therapeutic response among the various anticholinergic agents used. Pressure reduction was achieved in 51.2% of patients receiving oxybutynin and in 75% of those treated with propiverine (Table 6) . Patients with bilateral VUR, high-grade reflux, or tower bladder morphology did not demonstrate a significantly different distribution of intravesical pressure responses compared to their counterparts. Similarly, no significant differences in mean BDR values were observed among patients with reduced, stable, or increased bladder pressures following anticholinergic therapy (p = 0.085). In patients who achieved 40 cmH₂O intravesical pressure at early bladder volumes (i.e., at one-half or one-quarter of expected capacity), pressure reduction following anticholinergic therapy was less likely, indicating potential structural resistance to pharmacological modulation (Table VI) . 5. Findings Related to Age-Adjusted Serum Creatinine Patients who received long-term anticholinergic therapy exhibited significantly elevated age-adjusted serum creatinine levels compared to those who did not (p = 0.001). However, when other clinical parameters were evaluated—such as the presence of VUR, tower bladder morphology, duration or timing of clean intermittent catheterization (CIC), and walking status—no statistically significant differences in age-adjusted creatinine levels were identified (all p > 0.05). Although creatinine levels tended to be higher in patients with prolonged CIC use or delayed initiation of catheterization, these associations did not reach statistical significance. Among the three anticholinergic agents administered, patients receiving tolterodine showed the highest proportion of creatinine levels above normal, but the difference across groups did not reach statistical significance (Table VII). These findings suggest that while anticholinergic therapy may be associated with worsening renal function in certain cases, the relationship is likely influenced by underlying bladder dynamics and structural damage rather than pharmacologic intervention alone. Discussion Neurogenic bladder is a significant functional disorder of the lower urinary tract resulting from congenital or acquired neurological conditions that impair neural control mechanisms. In the pediatric population, this dysfunction poses a substantial risk for progressive renal damage and long-term deterioration in quality of life [1-3]. In our study, spinal pathology was identified in approximately 75% of the patients, with operated myelomeningocele accounting for the most common etiology (61.6%), underscoring the strong association between this clinical condition and underlying congenital neurologic defects. In regions such as Turkey, where neural tube defects remain prevalent, the need to strengthen prenatal screening programs and promote folic acid supplementation during pregnancy should be emphasized [10]. Radiologically, the tower bladder morphology observed on VCUG is characterized by marked vertical elongation of the bladder dome and a narrowing of the bladder base. This structural deformation is thought to result from prolonged exposure to high intravesical pressure, which induces detrusor hypertrophy and loss of bladder wall elasticity. In our cohort, tower bladder was identified in 71.3% of patients, and these individuals exhibited significantly elevated intravesical pressures (mean: 46.2 ± 24.2 cmH₂O; p < 0.001). The positive correlation between BDR and intravesical pressure (r = 0.362; p < 0.001) further supports the premise that this morphological phenotype is not merely anatomical, but closely associated with clinically relevant functional impairment. Austin et al. (2016) similarly emphasized that intravesical pressures exceeding 40 cmH₂O serve as a critical predictor of progressive renal deterioration in pediatric patients [5]. To more objectively elucidate the relationship between tower bladder morphology and renal scarring, we conducted a receiver operating characteristic (ROC) analysis. The area under the curve (AUC = 1.00) demonstrated excellent diagnostic performance for BDR in predicting renal injury. A BDR cutoff value of >1.4 was strongly associated with the presence of renal scarring and may serve as an optimal threshold with high sensitivity and specificity. These findings suggest that a BDR >1.4 could act as a clinically meaningful surrogate marker for identifying high-risk patients, even in the absence of formal urodynamic evaluation. Whether tower bladder represents a static congenital anomaly or a progressive, potentially reversible morphological change remains unclear in the current literature. However, our findings support the latter hypothesis. Specifically, the significant association between delayed initiation of CIC and the presence of tower bladder suggests that this deformity may evolve over time as a consequence of sustained high intravesical pressure. Chronic pressure overload likely contributes to detrusor hypertrophy, reduced wall compliance, and structural rigidity, all of which manifest as increased BDR values. Notably, even among patients receiving conservative treatment-including CIC and anticholinergic therapy-intravesical pressure remained significantly elevated in those with tower bladder, suggesting that in advanced stages, this morphological change may be only partially reversible or potentially irreversible. Costa Monteiro et al. (2017) also highlighted the limited efficacy of delayed intervention in preserving bladder function in children with neurogenic bladder [7]. Therefore, tower bladder should not be considered a benign anatomical variation but rather a structural indicator of treatment-resistant, high-risk bladder dysfunction. Longitudinal prospective studies are needed to determine the temporal evolution of this deformity and to clarify its responsiveness to early intervention. In our study, elevated intravesical pressure was significantly associated with both high-grade VUR (Grades IV–V; p = 0.004) and renal cortical scarring observed on DMSA scintigraphy (p = 0.020). These findings are consistent with prior studies indicating that elevated bladder pressures and reflux synergistically contribute to upper urinary tract deterioration in children with neurogenic bladder (11).These findings reinforce the central role of bladder pressure in the pathogenesis of upper urinary tract injury. Pohl et al. (2017) similarly emphasized that failure to adequately control bladder pressure may result in persistent VUR and irreversible renal damage [3]. CIC and anticholinergic pharmacotherapy constitute the cornerstone of conservative management in pediatric neurogenic bladder, aiming to reduce intravesical pressure and prevent upper urinary tract deterioration by minimizing urinary stasis and infection risk. Although the CIC initiation rate in our study was high (75.6%), the mean age at initiation (5.2 years) indicates a substantial delay in intervention. Previous studies, including that by Kiddoo et al. (2014), have shown that early initiation of CIC can prevent the development of irreversible structural changes in the bladder [6]. In our cohort, the significantly higher incidence of tower bladder in patients with delayed CIC initiation (p = 0.019) supports the notion of its progressive and potentially irreversible nature. Anticholinergic agents aim to suppress detrusor overactivity, thereby increasing bladder capacity and lowering intravesical pressure. In our study, more than 60% of patients received anticholinergic treatment, and a significant reduction in bladder pressure was achieved (p < 0.001). However, the absence of a statistically significant association between pressure changes and the duration of therapy, as well as the lack of efficacy differences between agents, suggests that structural alterations may limit pharmacologic responsiveness in more advanced cases [9]. The observed correlation between BDR and intravesical pressure is particularly valuable in clinical scenarios where urodynamic evaluation is not feasible. Furthermore, the significantly elevated BDR in non-walking patients and in those with obstructive patterns on DTPA suggests that this morphological metric may reflect not only bladder dysfunction but also the severity of underlying neurologic impairment. Elevated bladder pressures occurring prior to the development of overt tower bladder should be regarded as an early warning sign, warranting prompt intervention. If conservative management is not initiated in a timely manner, the combination of sustained intravesical pressure and reflux may result in irreversible renal damage. In such cases—particularly among patients with low bladder capacity, high pressures, and severe reflux—fibrotic changes may render conservative therapy insufficient and necessitate surgical intervention. Finally, the impact of socioeconomic factors on the management of neurogenic bladder must not be overlooked. Batra et al. (2020) have shown that socioeconomic disadvantage contributes to delayed diagnosis and restricted access to treatment in resource-limited settings [8]. In our cohort, only 41.5% of mothers reported folic acid supplementation during pregnancy, and refugee patients (20.7%) frequently experienced barriers to care. These findings underscore the need for population-level interventions, including educational and screening programs, to enhance early diagnosis and preventive care strategies [3]. In conclusion, tower bladder should be recognized not merely as an anatomical variant, but as a clinically significant morphological marker indicative of high intravesical pressure, structural progression, and limited reversibility. The integration of radiological and functional markers is essential in establishing individualized management plans and preventing long-term renal sequelae in pediatric patients with neurogenic bladder. Recommendations Based on the findings of this study, the following clinical recommendations are proposed to optimize the management of pediatric neurogenic bladder: Early Diagnosis and Intervention: Children at high risk for neurogenic bladder—particularly those with myelomeningocele or spinal dysraphism—should undergo regular follow-up and early urodynamic evaluation beginning in the neonatal period. An intravesical pressure of ≥40 cmH₂O should be regarded as a critical threshold indicating the need for prompt conservative treatment. Patients with a BDR >1.4 should be closely monitored for complications associated with tower bladder morphology and elevated bladder pressure. Although a universal cutoff value for BDR has not yet been established in the literature, our findings suggest that BDR values exceeding 1.5, particularly in children who reach critical pressure at early filling stages, may indicate significant morphological progression. In cases where urodynamic testing is not feasible, BDR >1.4 may serve as a practical morphological warning criterion in clinical practice. Individualized Treatment Planning: Therapeutic decision-making should be guided by a comprehensive assessment of urodynamic parameters, VUR grade, renal function, and bladder morphology. CIC and anticholinergic therapy protocols should be personalized and initiated as early as possible based on this integrated evaluation. Regular and Proactive Monitoring: Patients should undergo periodic assessment of urodynamic parameters, BDR, serum creatinine levels, and renal scarring via DMSA scans. Those with BDR >1.4 and/or intravesical pressure ≥40 cmH₂O should be classified as high-risk and closely monitored to prevent irreversible renal damage. Community-Based Awareness and Preventive Health Services: Public health initiatives should target populations with low socioeconomic status and refugee backgrounds to improve awareness of folic acid use, prenatal screening, and early diagnosis of neurogenic bladder. Educational programs, community-based screening, and increased access to pediatric urology services are essential for early intervention and renal protection. Declarations Conflict of Interest Statement: The authors declare no conflict of interest. Funding Statement: No external funding was received for this study. The authors have no financial or proprietary interests in any material discussed in this article. Competing interests The authors have no financial or proprietary interests in any material discussed in this article. Ethics approval This retrospective study was approved by the Institutional Ethics Committee (Approval No: 2024/40), and the requirement for informed consent was waived. Consent to participate Not applicable. Authors' contributions Derya Yayla performed the study design and statistical analysis; Güneş Işık contributed to data collection and literature review. Both authors reviewed and approved the final manuscript. References Gormley, E. A., Lightner, D. J., & Faraday, M. (2019). Diagnosis and management of neurogenic bladder in children. Urology Clinics of North America, 46(4), 515–530. Defoor, W., Minevich, E., & Reddy, P. P. (2020). Long-term outcomes of children with neurogenic bladder dysfunction. Pediatric Nephrology, 35(4), 561–569. Kliegman, R. M., St. Geme, J. W., Blum, N. J., Shah, S. S., Tasker, R. C., & Wilson, K. M. (2020). Nelson Textbook of Pediatrics (21st ed., Vol. 1, pp. 3844–3845). Elsevier. Pohl, H. G., Rushton, H. G., & Park, J. M. (2017). The management of high-grade vesicoureteral reflux in children. The New England Journal of Medicine, 376(8), 758–769. Austin, J. C., Cooper, C. S., & Boyt, M. A. (2016). Neurogenic bladder in children: Principles of diagnosis and management. The Journal of Urology, 195(6), 1615–1623. 6. Kiddoo, D., Sawatzky, B., & Bascu, D. (2014). Clean intermittent catheterization in children with neurogenic bladder: A practical guide. Canadian Urological Association Journal, 8(7-8), E524–E528. Costa Monteiro, L. M., Cruz, G. O., Fontes, J. M., Vieira, E. T. R. C., Santos, E. N., Araújo, G. F., & Ramos, E. G. (2017). Early treatment improves urodynamic prognosis in neurogenic voiding dysfunction: 20 years of experience. Jornal de Pediatria, 93(4), 420–427. https://doi.org/10.1016/j.jped.2016.11.010 Batra, P., Singh, J., & Kant, S. (2020). Socioeconomic disparities in access to care for neurogenic bladder in resource-constrained settings. Journal of Pediatric Urology, 16(5), 593.e1–593.e6. Robson, W. L. M., Leung, A. K. C., & Thomason, M. A. (2018). Anticholinergic therapy in the treatment of pediatric neurogenic bladder. International Urology and Nephrology, 50(4), 703–710. Ginsberg, D. (2013). The epidemiology and pathophysiology of neurogenic bladder. The American Journal of Managed Care, 19(10 Suppl), S191–S198. Ekberli G, Taner S. Risk determination for upper urinary tract damage in children with neuropathic bladder. J Paediatr Child Health. 2023 Jul;59(7):863-870. doi:10.1111/jpc.16402. PMID: 36999336. Tables Table I. Demographic, Clinical, and Radiological Characteristics of the Study Population (n = 164) Parameter Value Age, years (mean ± SD) 7.7 ± 4.6 Sex, n (%) Male: 81 (49.4%), Female: 83 (50.6%) Walking status, n (%) Walking: 85 (51.8%) Ethnicity, n (%) Turkish: 130 (79.3%), Syrian: 34 (20.7%) Maternal folic acid supplementation, n (%) 68 (41.5%) Maternal age at childbirth, years (mean ± SD) 26.9 ± 5.1 Serum creatinine, mg/dL (mean ± SD) 0.52 ± 0.52 Age-adjusted creatinine levels, n (%) Normal: 146 (89%) Mildly elevated: 10 (6.1%) Twice normal: 5 (3.0%) Severely elevated: 3 (1.8%) Bladder wall thickness, mm (mean ± SD) 6.7 ± 3.2 Bladder Diameter Ratio (BDR), (mean ± SD) 1.375 ± 0.29 Bladder capacity, cc (mean ± SD) 188.5 ± 108.8 Detrusor pressure, cm H₂O (mean ± SD) 40.6 ± 24.4 Post-void residual urine (PVR), cc (mean ± SD) 54.3 ± 42.0 Tower-shaped bladder, n (%) 117 (71.3%) Vesicoureteral reflux (VUR), n (%) Absent: 80 (48.8%) Grade 1-3: 16 (9.8%) Grade 4,5: 68 (41.5%) DTPA renal scan, n (%) Not performed: 134 (81.7%) Obstruction present: 26 (15.9%) Obstruction absent: 4 (2.4%) DMSA scan findings, n (%) No damage: 63 (38.9%) 10% function loss: 32 (19.8%) 20% loss: 28 (17.3%) 30% loss: 25 (15.4%) 40% loss: 8 (4.9%) Single kidney: 6 (3.7%) Antibiotic prophylaxis, n (%) 104 (63.4%) Recurrent urinary tract infections (UTIs), n (%) 87 (53.0%) Hypertension, n (%) 5 (3.0%) Megaureter, n (%) 74 (45.4%) Overnight catheterization, n (%) 9 (5.5%) Intradetrusor botulinum toxin injection, n (%) 39 (23.8%) Vesicostomy, n (%) 3 (1.8%) VUR endoscopic injection treatment, n (%) 22 (13.4%) Clean Intermittent Catheterization (CIC), n (%) 124 (75.6%) Duration of CIC, months (mean ± SD) 22.6 ± 31.7 Age at CIC initiation, years (mean ± SD) 5.2 ± 4.7 Anticholinergic use, n (%) None: 65 (39.6%) Oxybutynin: 66 (40.2%) Tolterodine: 16 (9.8%) Propiverine: 17 (10.4%) Duration of anticholinergic therapy, months (mean ± SD) 11.6 ± 22.7 Table II. Factors Associated with Intravesical Pressure Bladder Pressure P value* Correlation Coefficient Age 0,161 0,040 Mother's Age at Delivery -0,020 0,800 Creatinine 0,168 0,031 Bladder Wall Thickness 0,058 0,457 Bladder Diameter Ratio (BDR) 0,362 <0,001 PVR Amount 0,201 0,024 Duration of CIC (months) 0,302 <0,001 Age at CIC initiation -0,019 0,826 Duration of Anticholinergic Use 0,286 <0,001 Bladder Capacity All patients No VUR Grade 1-2-3 VUR Grade 4-5 VUR -0,095 -0,090 -0,307 -0,068 0,224 0,428 0,248 0,580 Ort±ss p** Walking Ability Present Absent 40,0±25,4 41,2±23,5 0,753*** Tower Bladder Absent Present 26,7±19,1 46,2±24,2 <0,001*** Creatinine by Age Normal Above Normal 2x Normal Very High 38,3±24,0 49,7±17,3 70,6±19,0 73,0±7,5 0,001 DMSA Damage No Damage %10 Decrease %20 Decrease %30 Decrease %40 Decrease Single Kidney 35,0±23,7 39,5±18,4 47,6±32,1 46,7±23,1 44,0±17,4 51,3±24,8 0,128 CIC Usage No Yes 34,8±25,8 42,5±23,8 0,082*** VUR None VUR Grade1-2-3 VUR Grade 4-5 34,6±22,4 42,7±20,8 47,2±26,0 0,006 Anticholinergic Use None Oxybutynin Tolteradine Propiverine 30,5±18,6 43,4±24,1 52,9±27,3 56,9±27,7 <0,001 * Pearson correlation test **ANOVA test ***Student2s t test Table III. Factors Associated with Bladder Diameter Ratio (BDR) Bladder Diameter Ratio P value* mean±SD/r Patient mobility Yes 1.321±0.28 0,008*** No 1.439±28,9 DTPA Obstruction Absent 1.335±0.26 0,001*** Present 1.583±0.32 Age-Adjusted Serum Creatinine Normal 1.352±0.27 0,005* Above Normal 1.502±0.25 Twice the Normal 1.744±0.44 Markedly Elevated 1.593±0.24 Bladder Filling Volume at 40 cm H₂O Pressure None 1.269±0.25 <0,001* Full Capacity 1.429±0.22 Half Capacity 1.515±0.29 One-quarter Capacity 1.581±0.21 Correlation Coefficient Bladder Capacity All Patients -0,028 0,726* Patients with Tower-shaped Bladder -0,007 0,937* Bladder Pressure All Patients 0,362 <0,001* Patients with Tower-shaped Bladder 0,184 0,048* * Pearson correlation test **ANOVA test ***Student’s t test Table IV. Relationship Between Tower-Shaped Bladder and Associated Factors [n (%)] Tower-Shaped Bladder P value * Absent Present Ethnicity Turkish 41 (87,2) 89 (76,1) 0,167 Syrian 6 (12,8) 28 (23,9) Etiology of Neurogenic Bladder Operated MMC 22 (46,8) 79 (67,5) - Spina bifida 14 (29,8) 18 (15,4) VUR 5 (10,6) 13 (11,1) ARM 1 (2,1) 2 (1,7) DSD 4 (8,5) 3 (2,6) Urethral stricture 1 (2,1) 2 (1,7) Age-Adjusted Serum Creatinine Normal 46 (97,9) 100 (85,5) - Above Normal 1 (2,1) 9 (7,7) Twice the Normal 0 (0) 5 (4,3) Markedly Elevated 0 (0) 3 (2,6) DTPA Obstruction DTPA not performed 44 (32,8) 90 (67,2) - Present 2 (7,7) 24 (92,3) No obstruction 1 (25) 3 (75) Bladder Volume at 40 cm/H₂O Pressure No high pressure 41 (44,1) 52 (55,9) <0,001 At full bladder 3 (33,3) 6 (66,7) At half bladder volume 3 (6,8) 41 (93,2) At quarter bladder volume 0 (0) 18 (100) CIC Duration (mean ± SD) (month) 14,6±32,4 25,8±31,0 0,041** Age at CIC Initiation (mean ± SD) (year) 3,4±4,4 5,7±4,7 0,019** *Chi-square test **Student’s t test Table V. Comparison of bladder filling at 40 cm H₂O bladder pressure according to the clinical characteristics of the patients [n (%)] Clinical Characteristic Bladder filling at 40 cm H₂O bladder pressure P value * No high pressure Full Filling Half Filling Quarter Filling Maternal folic acid use Yes 37 (54,4) 5 (7,4) 19 (27,9) 7 (10,3) 0,814** No 56 (58,3) 4 (4,2) 25 (26) 11 (11,5) VUR Absent 55 (68,8) 4 (5) 14 (17,5) 7 (8,8) - VUR Grade 1-3 10 (62,5) 0 (0) 4 (25) 2 (12,5) VUR Grade 4-5 28 (41,2) 5 (7,4) 26 (38,2) 9 (13,2) Bilateral VUR Absent 79 (60,8) 6 (4,6) 32 (24,6) 13 (10) - Present 14 (41,2) 3 (8,8) 12 (35,3) 5 (14,7) Tower-shaped bladder Absent 41 (87,2) 3 (6,4) 3 (6,4) 0 (0) <0,001 ** Present 52 (44,4) 6 (5,1) 41 (35) 18 (15,4) Anticholinergic treatment None 49 (75,4) 2 (3,1) 11 (16,9) 3 (4,6) - Oxybutynin 36 (54,5) 3 (4,5) 16 (24,2) 11 (16,7) Tolterodine 5 (31,3) 3 (18,8) 7 (43,8) 1 (6,3) Propiverine 3 (17,6) 1 (5,9) 10 (58,8) 3 (17,6) Post-void residual (PVR , mean ± SD) Able to walk 49,7±45,2 89,7±81,1 59,2±34 48,4±21,3 0,223 Unable to walk 51,1±40,1 40 55,4±24,3 58,4±37,3 0,938 Duration of CIC (mean ± SD, months) 16,7±29,8 23,8±30,7 28±32,7 39,6±33,4 0,020 Age of CIC initiation (mean ± SD) 5±4,8 5,6±3,4 5,8±4,9 4,5±4 0,785 Maternal age (mean ± SD) 26,8±4,8 24,8±3,2 27,6±5,7 26,3±6 0,439 *ANOVA testi ** Chi-square test Table VI. Changes in Intravesical Pressure in Patients Receiving Anticholinergic Therapy Bladder pressure changes P value* No Change Decrease Increase VUR Absent 12 (34,3) 19 (54,3) 4 (11,4) - VUR Grade 1-3 2 (40) 2 (40) 1 (20) VUR Grade 4-5 11 (28,2) 16 (41) 12 (30,8) Bilateral VUR Absent 19 (33,3) 29 (50,9) 9 (15,8) 0,134** Present 6 (27,3) 8 (36,4) 8 (36,4) Tower-shaped bladder Absent 2 (14,3) 11 (78,6) 1 (7,1) - Present 23 (35,4) 26 (40) 16 (24,6) Bladder diameter ratio (mean ± SD) 1.484±0.25 1.379±0.29 1.549±0.24 0,085 Bladder pressure at 40 cm H₂O filling No high pressure 12 (37,5) 18 (56,3) 2 (6,3) - Full bladder 3 (42,9) 3 (42,9) 1 (14,3) Half-filled bladder 7 (24,1) 13 (44,8) 9 (31) Quarter-filled bladder 3 (27,3) 3 (27,3) 5 (45,5) Anticholinergic used None 2 (40) 2 (40) 1 (20) - Oxybutynin 10 (23,3) 22 (51,2) 11 (25,6) Tolterodine 11 (73,3) 1 (6,7) 3 (20) Propiverine 2 (12,5) 12 (75) 2 (12,5) PVR (mean ± SD) Walking 73,3±61,8 50,9±35,7 66,7±32 0,391 Non-walking 48,5±22,8 57±38,4 50,8±26,5 0,876 CIC use No 2 (20) 6 (60) 2 (20) - Yes 23 (33,3) 31 (44,9) 15 (21,7) Duration of CIC (mean ± SD) 35,5±33,1 25,3±27,9 38,4±40,7 0,299 Age at CIC initiation (mean ± SD) 4,7±3,9 6,3±4,5 3,5±3,3 0,080 *ANOVA test ** Chi-square test Table VII. Age-Adjusted Serum Creatinine Levels by Clinical Variables Age-Adjusted Serum Creatinine P value* Normal Above Normal Twice the Normal Markedly Elevated CIC use No 39 (97,5) 1 (2,5) 0 (0) 0 (0) - Yes 107 (86,3) 9 (7,3) 5 (4) 3 (2,4) Anticholinergic used None 60 (92,3) 3 (4,6) 1 (1,5) 1 (1,5) - Oxybutynin 61 (92,4) 3 (4,5) 1 (1,5) 1 (1,5) Tolterodine 11 (68,8) 2 (12,5) 2 (12,5) 1 (6,3) Propiverine 14 (82,4) 2 (11,8) 1 (5,9) 0 (0) VUR Absent 76 (95) 1 (1,3) 1 (1,3) 2 (2,5) - VUR Grade1-3 15 (93,8) 1 (6,3) 0 (0) 0 (0) VUR Grade 4-5 55 (80,9) 8 (11,8) 4 (5,9) 1 (1,5) Bilateral VUR Absent 120 (92,3) 4 (3,1) 3 (2,3) 3 (2,3) - Present 26 (76,5) 6 (17,6) 2 (5,9) 0 (0) Duration of CIC (mean ± SD) 20,5±30,6 43,9±38 33,6±41,9 37±30 0,093 Age at CIC initiation (mean ± SD) 4,9±4,6 7,1±5,4 6,8±5,4 7,3±6,7 0,377 Duration of Anticholinergic Use 9,5±18,8 25,6±33,7 45,2±59,6 9,7±12,7 0,001 *ANOVA test Supplementary Files towerbladderlatex.tex Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6895753","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":472559785,"identity":"e4ce0242-c243-4b26-8d06-18d8a04b2c53","order_by":0,"name":"DERYA YAYLA","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAyElEQVRIiWNgGAWjYDCCAyCigEGOgYGHJC0GDMaka0lsIFoL3+0zhp95DOzSNxw/e/DBBwY7Od0GAlokz+UYS/MYJOduOJOXbDiDIdnY7AABLQZneAyAWphzNxzIMZPmYTiQuI0ILca/eQzq0w3OvyFeC1ClweEEgxvE2iJ5hq3Mco7BccOZN94YG84wIMIvfGeYN994U1Etz3c+x/DBhwo7OYJaGBg4DJhAMaIAVmlAUDkIsD9g/AGk5BuIUj0KRsEoGAUjEQAAOK5BNlCjJEYAAAAASUVORK5CYII=","orcid":"https://orcid.org/0000-0001-7811-5949","institution":"Izmir Il Saglik Mudurlugu","correspondingAuthor":true,"prefix":"","firstName":"DERYA","middleName":"","lastName":"YAYLA","suffix":""},{"id":472559786,"identity":"bd7ebf92-f28c-4325-85c0-f11f5705fe4b","order_by":1,"name":"Güneş Işık","email":"","orcid":"","institution":"Cumhuriyet Üniversitesi: Sivas Cumhuriyet Universitesi","correspondingAuthor":false,"prefix":"","firstName":"Güneş","middleName":"","lastName":"Işık","suffix":""}],"badges":[],"createdAt":"2025-06-14 22:00:25","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6895753/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6895753/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":85383259,"identity":"b69c133d-e36b-43f4-a4c8-389c0d2adaa5","added_by":"auto","created_at":"2025-06-25 09:35:54","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":309189,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eVCUG image of tower bladder morphology and BDR = 1.34\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA 12-year-old male patient with neurogenic bladder (post-operative MMC) and right Grade 4 VUR on VCUG. He has been performing clean intermittent catheterization (CIC) 6 times per day for 6 years, receiving antibiotic prophylaxis, is non-walking, and has been on antihypertensive medication for 1 year. The right kidney has 20% function, and serum creatinine is 0.9 mg/dL. Urodynamic study revealed a bladder pressure of 75 cm H₂O at a bladder capacity of 300 cc; the threshold pressure of 40 cm H₂O was reached at a volume of 150 cc.\u003c/p\u003e\n\u003cp\u003eBDR = Vertical Diameter / Horizontal Diameter\u003c/p\u003e\n\u003cp\u003eBDR = 77.07 mm / 57.14 mm ≈ 1.34\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-6895753/v1/1c72a9a75b715a8169ebb19e.png"},{"id":85383257,"identity":"ab7ac620-b534-4e00-8953-30cf7126d8c4","added_by":"auto","created_at":"2025-06-25 09:35:54","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":49843,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eReceiver Operating Characteristic (ROC) curve analysis of BDR for prediction of renal scarring \u003c/strong\u003e(AUC = 1.00).\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-6895753/v1/7f81e3c50c9aec61e851fe8e.png"},{"id":88277878,"identity":"b367d094-e531-4fde-8829-9bff572d7cb6","added_by":"auto","created_at":"2025-08-04 18:46:50","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2623057,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6895753/v1/ec4ef22e-4263-4d6c-a138-c9b361f4256c.pdf"},{"id":85383271,"identity":"4db80e98-48df-4768-abb2-c1581f4bae4f","added_by":"auto","created_at":"2025-06-25 09:35:55","extension":"tex","order_by":16,"title":"","display":"","copyAsset":false,"role":"supplement","size":30596,"visible":true,"origin":"","legend":"","description":"","filename":"towerbladderlatex.tex","url":"https://assets-eu.researchsquare.com/files/rs-6895753/v1/c8bbebb38c4ae5267d891a90.tex"}],"financialInterests":"","formattedTitle":"Tower Bladder: A Silent Threat in Pediatric Neurogenic Bladder – An Evaluation of Clinical Outcomes Based on Radiological and Urodynamic Markers","fulltext":[{"header":"Introduction","content":"\u003cp\u003eNeurogenic bladder is a severe functional disorder of the lower urinary tract resulting from congenital or acquired neurological pathologies that impair the neural control of bladder storage and voiding. In pediatric populations, the most common etiological factors include congenital spinal dysraphism syndromes, particularly myelomeningocele. In these patients, bladder dysfunction typically begins at birth and progresses with urological and nephrological complications. If left untreated, it may lead to irreversible pathologies such as VUR, hydronephrosis, renal cortical scarring, hypertension, and chronic renal disease [1,2]. In regions where neural tube defects are prevalent, the importance of prenatal screening and folic acid prophylaxis has been increasingly emphasized [3].\u003c/p\u003e\n\u003cp\u003eThe pathophysiology of neurogenic bladder involves significant urodynamic abnormalities such as detrusor-sphincter dyssynergia, decreased bladder compliance, detrusor overactivity, and elevated intravesical pressure. Notably, intravesical pressures exceeding 40 cmH₂O are considered a major predictor of upper urinary tract damage. Therefore, early identification and control of bladder pressures in high-risk pediatric patients is crucial for long-term preservation of renal function [4,5].\u003c/p\u003e\n\u003cp\u003eIn recent years, specific morphologic patterns identified via radiological imaging-particularly on VCUG-have been shown to reflect underlying functional abnormalities. One such pattern is the so-called \u0026ldquo;tower bladder,\u0026rdquo; characterized by pronounced vertical elongation of the bladder dome, a narrowed base, and typically associated with high-pressure voiding. Although the clinical significance of this morphological feature remains under investigation, there is growing evidence suggesting its association with elevated intravesical pressure, the presence of VUR, and renal scarring. The presence of tower bladder may not merely represent an anatomical variation, but rather indicate a high-risk bladder dysfunction phenotype. To objectively assess this structural abnormality, the BDR, defined as the ratio of vertical to horizontal dimensions on VCUG, has emerged as a quantifiable morphological marker. Failure to establish an early diagnosis or delay in initiating appropriate management in these patients may result in irreversible renal damage. Early initiation of CIC and anticholinergic pharmacotherapy plays a key role in reducing intravesical pressure and preventing upper urinary tract complications [6,7].\u003c/p\u003e\n\u003cp\u003eThis study aims to elucidate the prognostic value of tower bladder morphology in children with neurogenic bladder, and to investigate its relationship with radiological and urodynamic indicators. Furthermore, by analyzing the impact of conservative treatment timing on both morphological and functional parameters, we aim to provide clinical guidance for individualized management strategies\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003eThis retrospective, cross-sectional study included 164 pediatric patients (50.6% female, 49.4% male; mean age: 7.7 \u0026plusmn; 4.6 years) diagnosed with neurogenic bladder and managed at Gaziantep City Hospital between October 2023 and May 2024. The etiologies of neurogenic bladder were as follows:\u003c/p\u003e\n\u003cp\u003e\u0026bull; Operated myelomeningocele with associated spinal pathology: 32 patients (61.6%)\u003c/p\u003e\n\u003cp\u003e\u0026bull; Isolated spinal pathology: 18 patients (19.5%), including spina bifida (n=14), operated spinal tumors (n=4), and spinal trauma (n=1)\u003c/p\u003e\n\u003cp\u003e\u0026bull; Detrusor overactivity-related causes: Isolated VUR: 18 patients (11.0%), detrusor-sphincter dyssynergia (DSD): 7 patients (4.3%), operated anorectal malformation: 3 patients (1.8%), operated posterior urethral valve: 3 patients (1.8%)\u003c/p\u003e\n\u003cp\u003eSociodemographic variables\u0026mdash;including age, sex, nationality, maternal age at delivery, and maternal folic acid supplementation during pregnancy\u0026mdash;were recorded following approval from the institutional ethics committee (Ethics Approval No: 2024/40). Walking status was also documented as a surrogate marker of neurologic impairment severity. Pediatric age-specific reference ranges for serum creatinine levels were interpreted in accordance with the Nelson Textbook of Pediatrics to account for developmental renal function variation (3).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRadiological Assessment:\u0026nbsp;\u003c/strong\u003eImaging modalities included US, VCUG, and nuclear scintigraphy (DMSA and, when applicable, DTPA scans). US was used to evaluate bladder wall thickness, ureteral dilatation, and post-void residual (PVR) urine volume. VCUG was utilized to assess bladder morphology and grade VUR. The BDR was calculated as the vertical-to-horizontal dimension ratio \u003cstrong\u003e(Figure I).\u003c/strong\u003e Tower bladder morphology was defined as the presence of vertical elongation of the bladder dome on VCUG in conjunction with a BDR \u0026gt;1. DMSA scintigraphy was used to quantify renal cortical damage, and obstructive patterns were recorded on DTPA scans when performed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eUrodynamic Assessment:\u0026nbsp;\u003c/strong\u003eUrodynamic studies included evaluations of bladder capacity, intravesical pressure, bladder compliance, and the volume at which intravesical pressure reached 40 cmH₂O. In addition, the following treatment-related variables were documented: age at initiation and duration of CIC, type and duration of anticholinergic therapy, administration of intradetrusor botulinum toxin, performance of vesicostomy, and bladder augmentation procedures.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTherapeutic Interventions:\u0026nbsp;\u003c/strong\u003eThe management strategies implemented in these patients included;\u003c/p\u003e\n\u003cp\u003eCIC: Performed in 124 patients (75.6%), with a mean initiation age of 5.2 \u0026plusmn; 4.7 years and a mean duration of 22.6 \u0026plusmn; 31.7 months\u003c/p\u003e\n\u003cp\u003ePharmacologic therapy: Oral anticholinergics: oxybutynin (40.2%), propiverine (10.4%), and tolterodine (9.8%)\u003c/p\u003e\n\u003cp\u003eIntradetrusor botulinum toxin injections: 39 patients (23.8%)\u003c/p\u003e\n\u003cp\u003eSubureteric injection for VUR management: 22 patients (13.4%)\u003c/p\u003e\n\u003cp\u003eVesicostomy: 3 patients (1.8%)\u003c/p\u003e\n\u003cp\u003eBladder augmentation: 3 patients (1.8%) \u003cstrong\u003e(Table I)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical Analysis:\u0026nbsp;\u003c/strong\u003eAll statistical analyses were conducted using IBM SPSS Statistics version 26.0. Continuous variables were expressed as mean \u0026plusmn; standard deviation (SD), and categorical variables as frequencies and percentages. The Kolmogorov\u0026ndash;Smirnov test was employed to assess data distribution normality. Between-group comparisons were performed using the independent samples t-test, ANOVA, and chi-square test. Post hoc analyses (Bonferroni or Tukey) were applied where appropriate. Correlations between continuous variables were analyzed using Pearson\u0026rsquo;s correlation coefficient. A p-value of \u0026lt;0.05 was considered statistically significant.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003e1. Findings Related to Intravesical Pressure (Table II)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAmong the 164 pediatric patients with neurogenic bladder included in the study, tower bladder morphology was identified in 71.3% of cases. This subgroup exhibited significantly higher mean intravesical pressure values (46.2 \u0026plusmn; 24.2 cmH₂O vs. 26.7 \u0026plusmn; 19.1 cmH₂O; p \u0026lt; 0.001), greater BDR (1.439 \u0026plusmn; 0.29 vs. 1.321 \u0026plusmn; 0.28; p = 0.008), and a markedly higher incidence of high-grade VUR (Grades IV\u0026ndash;V: 58.8% vs. 10.6%; p = 0.006) compared to those without tower bladder. Moreover, patients with tower bladder began CIC at significantly older ages (5.7 \u0026plusmn; 4.7 years vs. 3.4 \u0026plusmn; 4.4 years; p = 0.019). A positive correlation was observed between CIC duration and intravesical pressure (r = 0.302; p \u0026lt; 0.001).\u003c/p\u003e\n\u003cp\u003eIntravesical pressure was positively correlated with BDR (r = 0.362; p \u0026lt; 0.001), serum creatinine level (r = 0.168; p = 0.031), post-void residual volume (PVR) (r = 0.201; p = 0.024), and duration of anticholinergic therapy (r = 0.286; p \u0026lt; 0.001). Patients with renal scarring on DMSA scintigraphy demonstrated significantly higher intravesical pressure values (44.2 \u0026plusmn; 24.3 cmH₂O vs. 35.0 \u0026plusmn; 23.7 cmH₂O; p = 0.020).\u003c/p\u003e\n\u003cp\u003eChildren with serum creatinine levels exceeding twice the age-adjusted normal range exhibited significantly higher intravesical pressures compared to those with normal values (p = 0.015). Similarly, patients receiving anticholinergic therapy demonstrated significantly increased intravesical pressures relative to untreated counterparts (p \u0026lt; 0.001). In contrast, no statistically significant differences in intravesical pressure were observed among the various anticholinergic agents used (p \u0026gt; 0.05).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2. Findings Related to BDR (Table III)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA statistically significant difference in BDR values was observed depending on the bladder volume at which the intravesical pressure reached 40 cmH₂O (p \u0026lt; 0.001). Post hoc analysis revealed that patients who reached the threshold pressure at one-half or one-quarter of expected bladder capacity exhibited significantly higher BDR values compared to those who did not reach this threshold (both p \u0026lt; 0.001).\u003c/p\u003e\n\u003cp\u003eA moderate positive correlation was identified between BDR and intravesical pressure (r = 0.362; p \u0026lt; 0.001). No correlation was found between BDR and bladder capacity. In the overall cohort, a weak-to-moderate positive correlation was observed between BDR and intravesical pressure (r = 0.362; p \u0026lt; 0.001), whereas in the subgroup of patients with tower bladder, the correlation remained positive but was weaker (r = 0.184; p = 0.048).\u003c/p\u003e\n\u003cp\u003eBDR values were significantly higher in patients with obstructive patterns on DTPA scans (p = 0.001) and in those who were non-walking (p = 0.008). Furthermore, children whose serum creatinine values were more than twice the age-specific normal range exhibited the highest BDR values (p = 0.014).\u003c/p\u003e\n\u003cp\u003eTo assess the diagnostic utility of BDR in predicting renal scarring, a receiver operating characteristic (ROC) analysis was conducted. The area under the ROC curve (AUC) indicated high discriminative power, and a BDR cutoff value of \u0026gt;1.4 was identified as highly sensitive and specific for the prediction of renal damage \u003cstrong\u003e(Figure II).\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3. Findings Related to Tower Bladder\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAmong patients with tower bladder morphology, a significantly higher proportion reached an intravesical pressure of 40 cmH₂O at early bladder filling volumes (p \u0026lt; 0.001). Additionally, the presence of tower bladder was significantly associated with delayed initiation of CIC (p = 0.019) \u003cstrong\u003e(Table IV).\u003c/strong\u003e Patients who reached the threshold pressure of 40 cmH₂O at earlier stages of bladder filling demonstrated significantly elevated BDR values (p \u0026lt; 0.001), suggesting a parallel progression of morphological distortion and functional deterioration.\u003c/p\u003e\n\u003cp\u003eA significant positive association was observed between the duration of CIC and intravesical pressure (p \u0026lt; 0.001), indicating that prolonged catheterization was linked to higher bladder pressures. Moreover, the timing of CIC initiation was significantly associated with the degree of bladder fullness at which pressure elevation occurred (p = 0.020) \u003cstrong\u003e(Table V)\u003c/strong\u003e. These findings further support the hypothesis that both delayed intervention and impaired bladder compliance contribute to the development and progression of tower bladder morphology.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4. Outcomes Related to Therapeutic Interventions\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAmong the 74 patients who received anticholinergic therapy, no statistically significant association was found between changes in intravesical pressure and clinical improvement (p \u0026gt; 0.05). A reduction in intravesical pressure was observed in 44.6% of these patients, while an increase was recorded in 21.6%. There was no statistically significant difference in therapeutic response among the various anticholinergic agents used. Pressure reduction was achieved in 51.2% of patients receiving oxybutynin and in 75% of those treated with propiverine \u003cstrong\u003e(Table 6)\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003ePatients with bilateral VUR, high-grade reflux, or tower bladder morphology did not demonstrate a significantly different distribution of intravesical pressure responses compared to their counterparts. Similarly, no significant differences in mean BDR values were observed among patients with reduced, stable, or increased bladder pressures following anticholinergic therapy (p = 0.085). In patients who achieved 40 cmH₂O intravesical pressure at early bladder volumes (i.e., at one-half or one-quarter of expected capacity), pressure reduction following anticholinergic therapy was less likely, indicating potential structural resistance to pharmacological modulation \u003cstrong\u003e(Table VI)\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e5. Findings Related to Age-Adjusted Serum Creatinine\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePatients who received long-term anticholinergic therapy exhibited significantly elevated age-adjusted serum creatinine levels compared to those who did not (p = 0.001). However, when other clinical parameters were evaluated\u0026mdash;such as the presence of VUR, tower bladder morphology, duration or timing of clean intermittent catheterization (CIC), and walking status\u0026mdash;no statistically significant differences in age-adjusted creatinine levels were identified (all p \u0026gt; 0.05).\u003c/p\u003e\n\u003cp\u003eAlthough creatinine levels tended to be higher in patients with prolonged CIC use or delayed initiation of catheterization, these associations did not reach statistical significance. Among the three anticholinergic agents administered, patients receiving tolterodine showed the highest proportion of creatinine levels above normal, but the difference across groups did not reach statistical significance \u003cstrong\u003e(Table VII).\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThese findings suggest that while anticholinergic therapy may be associated with worsening renal function in certain cases, the relationship is likely influenced by underlying bladder dynamics and structural damage rather than pharmacologic intervention alone.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eNeurogenic bladder is a significant functional disorder of the lower urinary tract resulting from congenital or acquired neurological conditions that impair neural control mechanisms. In the pediatric population, this dysfunction poses a substantial risk for progressive renal damage and long-term deterioration in quality of life [1-3]. In our study, spinal pathology was identified in approximately 75% of the patients, with operated myelomeningocele accounting for the most common etiology (61.6%), underscoring the strong association between this clinical condition and underlying congenital neurologic defects. In regions such as Turkey, where neural tube defects remain prevalent, the need to strengthen prenatal screening programs and promote folic acid supplementation during pregnancy should be emphasized [10].\u003c/p\u003e\n\u003cp\u003eRadiologically, the tower bladder morphology observed on VCUG is characterized by marked vertical elongation of the bladder dome and a narrowing of the bladder base. This structural deformation is thought to result from prolonged exposure to high intravesical pressure, which induces detrusor hypertrophy and loss of bladder wall elasticity. In our cohort, tower bladder was identified in 71.3% of patients, and these individuals exhibited significantly elevated intravesical pressures (mean: 46.2 \u0026plusmn; 24.2 cmH₂O; p \u0026lt; 0.001). The positive correlation between BDR and intravesical pressure (r = 0.362; p \u0026lt; 0.001) further supports the premise that this morphological phenotype is not merely anatomical, but closely associated with clinically relevant functional impairment. Austin et al. (2016) similarly emphasized that intravesical pressures exceeding 40 cmH₂O serve as a critical predictor of progressive renal deterioration in pediatric patients [5].\u003c/p\u003e\n\u003cp\u003eTo more objectively elucidate the relationship between tower bladder morphology and renal scarring, we conducted a receiver operating characteristic (ROC) analysis. The area under the curve (AUC = 1.00) demonstrated excellent diagnostic performance for BDR in predicting renal injury. A BDR cutoff value of \u0026gt;1.4 was strongly associated with the presence of renal scarring and may serve as an optimal threshold with high sensitivity and specificity. These findings suggest that a BDR \u0026gt;1.4 could act as a clinically meaningful surrogate marker for identifying high-risk patients, even in the absence of formal urodynamic evaluation.\u003c/p\u003e\n\u003cp\u003eWhether tower bladder represents a static congenital anomaly or a progressive, potentially reversible morphological change remains unclear in the current literature. However, our findings support the latter hypothesis. Specifically, the significant association between delayed initiation of CIC and the presence of tower bladder suggests that this deformity may evolve over time as a consequence of sustained high intravesical pressure. Chronic pressure overload likely contributes to detrusor hypertrophy, reduced wall compliance, and structural rigidity, all of which manifest as increased BDR values. Notably, even among patients receiving conservative treatment-including CIC and anticholinergic therapy-intravesical pressure remained significantly elevated in those with tower bladder, suggesting that in advanced stages, this morphological change may be only partially reversible or potentially irreversible. Costa Monteiro et al. (2017) also highlighted the limited efficacy of delayed intervention in preserving bladder function in children with neurogenic bladder [7]. Therefore, tower bladder should not be considered a benign anatomical variation but rather a structural indicator of treatment-resistant, high-risk bladder dysfunction. Longitudinal prospective studies are needed to determine the temporal evolution of this deformity and to clarify its responsiveness to early intervention.\u003c/p\u003e\n\u003cp\u003eIn our study, elevated intravesical pressure was significantly associated with both high-grade VUR (Grades IV\u0026ndash;V; p = 0.004) and renal cortical scarring observed on DMSA scintigraphy (p = 0.020). These findings are consistent with prior studies indicating that elevated bladder pressures and reflux synergistically contribute to upper urinary tract deterioration in children with neurogenic bladder (11).These findings reinforce the central role of bladder pressure in the pathogenesis of upper urinary tract injury. Pohl et al. (2017) similarly emphasized that failure to adequately control bladder pressure may result in persistent VUR and irreversible renal damage [3].\u003c/p\u003e\n\u003cp\u003eCIC and anticholinergic pharmacotherapy constitute the cornerstone of conservative management in pediatric neurogenic bladder, aiming to reduce intravesical pressure and prevent upper urinary tract deterioration by minimizing urinary stasis and infection risk. Although the CIC initiation rate in our study was high (75.6%), the mean age at initiation (5.2 years) indicates a substantial delay in intervention. Previous studies, including that by Kiddoo et al. (2014), have shown that early initiation of CIC can prevent the development of irreversible structural changes in the bladder [6]. In our cohort, the significantly higher incidence of tower bladder in patients with delayed CIC initiation (p = 0.019) supports the notion of its progressive and potentially irreversible nature.\u003c/p\u003e\n\u003cp\u003eAnticholinergic agents aim to suppress detrusor overactivity, thereby increasing bladder capacity and lowering intravesical pressure. In our study, more than 60% of patients received anticholinergic treatment, and a significant reduction in bladder pressure was achieved (p \u0026lt; 0.001). However, the absence of a statistically significant association between pressure changes and the duration of therapy, as well as the lack of efficacy differences between agents, suggests that structural alterations may limit pharmacologic responsiveness in more advanced cases [9].\u003c/p\u003e\n\u003cp\u003eThe observed correlation between BDR and intravesical pressure is particularly valuable in clinical scenarios where urodynamic evaluation is not feasible. Furthermore, the significantly elevated BDR in non-walking patients and in those with obstructive patterns on DTPA suggests that this morphological metric may reflect not only bladder dysfunction but also the severity of underlying neurologic impairment.\u003c/p\u003e\n\u003cp\u003eElevated bladder pressures occurring prior to the development of overt tower bladder should be regarded as an early warning sign, warranting prompt intervention. If conservative management is not initiated in a timely manner, the combination of sustained intravesical pressure and reflux may result in irreversible renal damage. In such cases\u0026mdash;particularly among patients with low bladder capacity, high pressures, and severe reflux\u0026mdash;fibrotic changes may render conservative therapy insufficient and necessitate surgical intervention.\u003c/p\u003e\n\u003cp\u003eFinally, the impact of socioeconomic factors on the management of neurogenic bladder must not be overlooked. Batra et al. (2020) have shown that socioeconomic disadvantage contributes to delayed diagnosis and restricted access to treatment in resource-limited settings [8]. In our cohort, only 41.5% of mothers reported folic acid supplementation during pregnancy, and refugee patients (20.7%) frequently experienced barriers to care. These findings underscore the need for population-level interventions, including educational and screening programs, to enhance early diagnosis and preventive care strategies [3].\u003c/p\u003e\n\u003cp\u003eIn conclusion, tower bladder should be recognized not merely as an anatomical variant, but as a clinically significant morphological marker indicative of high intravesical pressure, structural progression, and limited reversibility. The integration of radiological and functional markers is essential in establishing individualized management plans and preventing long-term renal sequelae in pediatric patients with neurogenic bladder.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRecommendations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBased on the findings of this study, the following clinical recommendations are proposed to optimize the management of pediatric neurogenic bladder:\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003e\u003cem\u003eEarly Diagnosis and Intervention:\u003c/em\u003e\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eChildren at high risk for neurogenic bladder\u0026mdash;particularly those with myelomeningocele or spinal dysraphism\u0026mdash;should undergo regular follow-up and early urodynamic evaluation beginning in the neonatal period.\u003c/p\u003e\n\u003cp\u003eAn intravesical pressure of \u0026ge;40 cmH₂O should be regarded as a critical threshold indicating the need for prompt conservative treatment.\u003c/p\u003e\n\u003cp\u003ePatients with a BDR \u0026gt;1.4 should be closely monitored for complications associated with tower bladder morphology and elevated bladder pressure. Although a universal cutoff value for BDR has not yet been established in the literature, our findings suggest that BDR values exceeding 1.5, particularly in children who reach critical pressure at early filling stages, may indicate significant morphological progression. In cases where urodynamic testing is not feasible, BDR \u0026gt;1.4 may serve as a practical morphological warning criterion in clinical practice.\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003e\u003cem\u003eIndividualized Treatment Planning:\u003c/em\u003e\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eTherapeutic decision-making should be guided by a comprehensive assessment of urodynamic parameters, VUR grade, renal function, and bladder morphology. CIC and anticholinergic therapy protocols should be personalized and initiated as early as possible based on this integrated evaluation.\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003e\u003cem\u003eRegular and Proactive Monitoring:\u003c/em\u003e\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003ePatients should undergo periodic assessment of urodynamic parameters, BDR, serum creatinine levels, and renal scarring via DMSA scans. Those with BDR \u0026gt;1.4 and/or intravesical pressure \u0026ge;40 cmH₂O should be classified as high-risk and closely monitored to prevent irreversible renal damage.\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003e\u003cem\u003eCommunity-Based Awareness and Preventive Health Services:\u003c/em\u003e\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003ePublic health initiatives should target populations with low socioeconomic status and refugee backgrounds to improve awareness of folic acid use, prenatal screening, and early diagnosis of neurogenic bladder. Educational programs, community-based screening, and increased access to pediatric urology services are essential for early intervention and renal protection.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eConflict of Interest Statement:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding Statement:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo external funding was received for this study. The authors have no financial or proprietary interests in any material discussed in this article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eCompeting interests\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no financial or proprietary interests in any material discussed in this article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eEthics approval\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis retrospective study was approved by the Institutional Ethics Committee (Approval No: 2024/40), and the requirement for informed consent was waived.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eConsent to participate\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAuthors\u0026apos; contributions\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDerya Yayla performed the study design and statistical analysis; G\u0026uuml;neş Işık contributed to data collection and literature review. Both authors reviewed and approved the final manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eGormley, E. A., Lightner, D. J., \u0026amp; Faraday, M. (2019). Diagnosis and management of neurogenic bladder in children. Urology Clinics of North America, 46(4), 515\u0026ndash;530.\u003c/li\u003e\n \u003cli\u003eDefoor, W., Minevich, E., \u0026amp; Reddy, P. P. (2020). Long-term outcomes of children with neurogenic bladder dysfunction. Pediatric Nephrology, 35(4), 561\u0026ndash;569.\u003c/li\u003e\n \u003cli\u003eKliegman, R. M., St. Geme, J. W., Blum, N. J., Shah, S. S., Tasker, R. C., \u0026amp; Wilson, K. M. (2020). Nelson Textbook of Pediatrics (21st ed., Vol. 1, pp. 3844\u0026ndash;3845). Elsevier.\u003c/li\u003e\n \u003cli\u003ePohl, H. G., Rushton, H. G., \u0026amp; Park, J. M. (2017). The management of high-grade vesicoureteral reflux in children. The New England Journal of Medicine, 376(8), 758\u0026ndash;769.\u003c/li\u003e\n \u003cli\u003eAustin, J. C., Cooper, C. S., \u0026amp; Boyt, M. A. (2016). Neurogenic bladder in children: Principles of diagnosis and management. The Journal of Urology, 195(6), 1615\u0026ndash;1623.\u003c/li\u003e\n \u003cli\u003e6. Kiddoo, D., Sawatzky, B., \u0026amp; Bascu, D. (2014). Clean intermittent catheterization in children with neurogenic bladder: A practical guide. Canadian Urological Association Journal, 8(7-8), E524\u0026ndash;E528.\u003c/li\u003e\n \u003cli\u003eCosta Monteiro, L. M., Cruz, G. O., Fontes, J. M., Vieira, E. T. R. C., Santos, E. N., Ara\u0026uacute;jo, G. F., \u0026amp; Ramos, E. G. (2017). Early treatment improves urodynamic prognosis in neurogenic voiding dysfunction: 20 years of experience. Jornal de Pediatria, 93(4), 420\u0026ndash;427. https://doi.org/10.1016/j.jped.2016.11.010\u003c/li\u003e\n \u003cli\u003eBatra, P., Singh, J., \u0026amp; Kant, S. (2020). Socioeconomic disparities in access to care for neurogenic bladder in resource-constrained settings. Journal of Pediatric Urology, 16(5), 593.e1\u0026ndash;593.e6.\u003c/li\u003e\n \u003cli\u003eRobson, W. L. M., Leung, A. K. C., \u0026amp; Thomason, M. A. (2018). Anticholinergic therapy in the treatment of pediatric neurogenic bladder. International Urology and Nephrology, 50(4), 703\u0026ndash;710.\u003c/li\u003e\n \u003cli\u003eGinsberg, D. (2013). The epidemiology and pathophysiology of neurogenic bladder. The American Journal of Managed Care, 19(10 Suppl), S191\u0026ndash;S198.\u003c/li\u003e\n \u003cli\u003eEkberli G, Taner S. Risk determination for upper urinary tract damage in children with neuropathic bladder. J Paediatr Child Health. 2023 Jul;59(7):863-870. doi:10.1111/jpc.16402. PMID: 36999336.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable I. Demographic, Clinical, and Radiological Characteristics of the Study Population\u003c/strong\u003e (n = 164)\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 314px;\"\u003e\n \u003cp\u003eParameter\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eValue\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 314px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge, years\u0026nbsp;\u003c/strong\u003e(mean \u0026plusmn; SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e7.7 \u0026plusmn; 4.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 314px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eMale: 81 (49.4%), Female: 83 (50.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 314px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWalking status, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eWalking: 85 (51.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 314px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEthnicity, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eTurkish: 130 (79.3%), Syrian: 34 (20.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 314px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMaternal folic acid supplementation, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e\u0026nbsp;68 (41.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 314px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMaternal age at childbirth, years (mean \u0026plusmn; SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e26.9 \u0026plusmn; 5.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 314px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSerum creatinine, mg/dL (mean \u0026plusmn; SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e0.52 \u0026plusmn; 0.52\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 314px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge-adjusted creatinine levels, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eNormal: 146 (89%)\u003cbr\u003e\u0026nbsp;Mildly elevated: 10 (6.1%)\u003cbr\u003e\u0026nbsp;Twice normal: 5 (3.0%)\u003cbr\u003e\u0026nbsp;Severely elevated: 3 (1.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 314px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBladder wall thickness, mm\u0026nbsp;\u003c/strong\u003e(mean \u0026plusmn; SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e6.7 \u0026plusmn; 3.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 314px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBladder Diameter Ratio (BDR),\u0026nbsp;\u003c/strong\u003e(mean \u0026plusmn; SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e1.375 \u0026plusmn; 0.29\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 314px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBladder capacity, cc\u0026nbsp;\u003c/strong\u003e(mean \u0026plusmn; SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e188.5 \u0026plusmn; 108.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 314px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDetrusor pressure, cm H₂O\u0026nbsp;\u003c/strong\u003e(mean \u0026plusmn; SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e40.6 \u0026plusmn; 24.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 314px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePost-void residual urine (PVR), cc\u0026nbsp;\u003c/strong\u003e(mean \u0026plusmn; SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e54.3 \u0026plusmn; 42.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 314px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTower-shaped bladder, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e117 (71.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 314px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVesicoureteral reflux (VUR), n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eAbsent: 80 (48.8%)\u003cbr\u003e\u0026nbsp;Grade 1-3: 16 (9.8%)\u003cbr\u003e\u0026nbsp;Grade 4,5: 68 (41.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 314px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDTPA renal scan, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eNot performed: 134 (81.7%)\u003cbr\u003e\u0026nbsp;Obstruction present: 26 (15.9%)\u003cbr\u003e\u0026nbsp;Obstruction absent: 4 (2.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 314px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDMSA scan findings, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eNo damage: 63 (38.9%)\u003cbr\u003e\u0026nbsp;10% function loss: 32 (19.8%)\u003cbr\u003e\u0026nbsp;20% loss: 28 (17.3%)\u003cbr\u003e\u0026nbsp;30% loss: 25 (15.4%)\u003cbr\u003e\u0026nbsp;40% loss: 8 (4.9%)\u003cbr\u003e\u0026nbsp;Single kidney: 6 (3.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 314px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAntibiotic prophylaxis, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e104 (63.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 314px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRecurrent urinary tract infections (UTIs), n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e\u0026nbsp;87 (53.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 314px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHypertension, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e\u0026nbsp;5 (3.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 314px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMegaureter, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e74 (45.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 314px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOvernight catheterization, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e\u0026nbsp;9 (5.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 314px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIntradetrusor botulinum toxin injection, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e\u0026nbsp;39 (23.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 314px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVesicostomy, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e\u0026nbsp;3 (1.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 314px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVUR endoscopic injection treatment, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e22 (13.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 314px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eClean Intermittent Catheterization (CIC), n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e124 (75.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 314px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDuration of CIC, months\u0026nbsp;\u003c/strong\u003e(mean \u0026plusmn; SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e22.6 \u0026plusmn; 31.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 314px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge at CIC initiation, years\u0026nbsp;\u003c/strong\u003e(mean \u0026plusmn; SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e5.2 \u0026plusmn; 4.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 314px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAnticholinergic use, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003eNone: 65 (39.6%)\u003cbr\u003e\u0026nbsp;Oxybutynin: 66 (40.2%)\u003cbr\u003e\u0026nbsp;Tolterodine: 16 (9.8%)\u003cbr\u003e\u0026nbsp;Propiverine: 17 (10.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 314px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDuration of anticholinergic therapy, months\u0026nbsp;\u003c/strong\u003e(mean \u0026plusmn; SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e11.6 \u0026plusmn; 22.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable II. Factors Associated with Intravesical Pressure\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" style=\"width: 293px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 146px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBladder Pressure\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 150px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eP value*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 146px;\"\u003e\n \u003cp\u003eCorrelation Coefficient\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 293px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 146px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,161\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 150px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,040\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 293px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMother\u0026apos;s Age at Delivery\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 146px;\"\u003e\n \u003cp\u003e-0,020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 150px;\"\u003e\n \u003cp\u003e0,800\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 293px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCreatinine\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 146px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,168\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 150px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,031\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 293px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBladder Wall Thickness\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 146px;\"\u003e\n \u003cp\u003e0,058\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 150px;\"\u003e\n \u003cp\u003e0,457\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 293px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBladder Diameter Ratio (BDR)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 146px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,362\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 150px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0,001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 293px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePVR Amount\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 146px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,201\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 150px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,024\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 293px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDuration of CIC\u0026nbsp;\u003c/strong\u003e(months)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 146px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,302\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 150px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0,001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 293px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge at CIC initiation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 146px;\"\u003e\n \u003cp\u003e-0,019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 150px;\"\u003e\n \u003cp\u003e0,826\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 293px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDuration of Anticholinergic Use\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 146px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,286\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 150px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0,001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBladder Capacity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003eAll patients\u003c/p\u003e\n \u003cp\u003eNo VUR\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eGrade 1-2-3 VUR\u003c/p\u003e\n \u003cp\u003eGrade 4-5 VUR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 146px;\"\u003e\n \u003cp\u003e-0,095\u003c/p\u003e\n \u003cp\u003e-0,090\u003c/p\u003e\n \u003cp\u003e-0,307\u003c/p\u003e\n \u003cp\u003e-0,068\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 150px;\"\u003e\n \u003cp\u003e0,224\u003c/p\u003e\n \u003cp\u003e0,428\u003c/p\u003e\n \u003cp\u003e0,248\u003c/p\u003e\n \u003cp\u003e0,580\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 293px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 146px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOrt\u0026plusmn;ss\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 150px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep**\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWalking Ability\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003ePresent\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eAbsent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 146px;\"\u003e\n \u003cp\u003e40,0\u0026plusmn;25,4\u003c/p\u003e\n \u003cp\u003e41,2\u0026plusmn;23,5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 150px;\"\u003e\n \u003cp\u003e0,753***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTower Bladder\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003eAbsent\u003c/p\u003e\n \u003cp\u003ePresent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 146px;\"\u003e\n \u003cp\u003e26,7\u0026plusmn;19,1\u003c/p\u003e\n \u003cp\u003e46,2\u0026plusmn;24,2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 150px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0,001***\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCreatinine by Age\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003cp\u003eAbove Normal\u003c/p\u003e\n \u003cp\u003e2x Normal\u003c/p\u003e\n \u003cp\u003eVery High\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 146px;\"\u003e\n \u003cp\u003e38,3\u0026plusmn;24,0\u003c/p\u003e\n \u003cp\u003e49,7\u0026plusmn;17,3\u003c/p\u003e\n \u003cp\u003e70,6\u0026plusmn;19,0\u003c/p\u003e\n \u003cp\u003e73,0\u0026plusmn;7,5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 150px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDMSA Damage\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003eNo Damage\u003c/p\u003e\n \u003cp\u003e%10 Decrease\u003c/p\u003e\n \u003cp\u003e%20 Decrease\u003c/p\u003e\n \u003cp\u003e%30 Decrease\u003c/p\u003e\n \u003cp\u003e%40 Decrease\u003c/p\u003e\n \u003cp\u003eSingle Kidney\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 146px;\"\u003e\n \u003cp\u003e35,0\u0026plusmn;23,7\u003c/p\u003e\n \u003cp\u003e39,5\u0026plusmn;18,4\u003c/p\u003e\n \u003cp\u003e47,6\u0026plusmn;32,1\u003c/p\u003e\n \u003cp\u003e46,7\u0026plusmn;23,1\u003c/p\u003e\n \u003cp\u003e44,0\u0026plusmn;17,4\u003c/p\u003e\n \u003cp\u003e51,3\u0026plusmn;24,8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 150px;\"\u003e\n \u003cp\u003e0,128\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCIC Usage\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 146px;\"\u003e\n \u003cp\u003e34,8\u0026plusmn;25,8\u003c/p\u003e\n \u003cp\u003e42,5\u0026plusmn;23,8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 150px;\"\u003e\n \u003cp\u003e0,082***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVUR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003cp\u003eVUR Grade1-2-3\u003c/p\u003e\n \u003cp\u003eVUR Grade 4-5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 146px;\"\u003e\n \u003cp\u003e34,6\u0026plusmn;22,4\u003c/p\u003e\n \u003cp\u003e42,7\u0026plusmn;20,8\u003c/p\u003e\n \u003cp\u003e47,2\u0026plusmn;26,0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 150px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,006\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 147px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAnticholinergic Use\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 147px;\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003cp\u003eOxybutynin\u003c/p\u003e\n \u003cp\u003eTolteradine\u0026nbsp;\u003c/p\u003e\n \u003cp\u003ePropiverine\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 146px;\"\u003e\n \u003cp\u003e30,5\u0026plusmn;18,6\u003c/p\u003e\n \u003cp\u003e43,4\u0026plusmn;24,1\u003c/p\u003e\n \u003cp\u003e52,9\u0026plusmn;27,3\u003c/p\u003e\n \u003cp\u003e56,9\u0026plusmn;27,7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 150px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0,001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e* Pearson correlation test \u0026nbsp;**ANOVA test \u0026nbsp;***Student2s t test\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable III. Factors Associated with Bladder Diameter Ratio (BDR)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" style=\"width: 333px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBladder Diameter Ratio\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eP value*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003emean\u0026plusmn;SD/r\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 197px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePatient mobility\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e1.321\u0026plusmn;0.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,008***\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e1.439\u0026plusmn;28,9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 197px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDTPA Obstruction\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003eAbsent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003e1.335\u0026plusmn;0.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,001***\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003ePresent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003e1.583\u0026plusmn;0.32\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" style=\"width: 197px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge-Adjusted Serum Creatinine\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003e1.352\u0026plusmn;0.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,005*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003eAbove Normal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003e1.502\u0026plusmn;0.25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003eTwice the Normal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003e1.744\u0026plusmn;0.44\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003eMarkedly Elevated\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003e1.593\u0026plusmn;0.24\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" style=\"width: 197px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBladder Filling Volume at 40 cm H₂O Pressure\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003e1.269\u0026plusmn;0.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0,001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003eFull Capacity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003e1.429\u0026plusmn;0.22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003eHalf Capacity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003e1.515\u0026plusmn;0.29\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003eOne-quarter Capacity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003e1.581\u0026plusmn;0.21\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 333px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003eCorrelation Coefficient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 197px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBladder Capacity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003eAll Patients\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e-0,028\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 110px;\"\u003e\n \u003cp\u003e0,726*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003ePatients with Tower-shaped Bladder\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e-0,007\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 110px;\"\u003e\n \u003cp\u003e0,937*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 197px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBladder Pressure\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003eAll Patients\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e0,362\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0,001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003ePatients with Tower-shaped Bladder\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e0,184\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,048*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e* Pearson correlation test \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;**ANOVA test \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; ***Student\u0026rsquo;s t test\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable IV. Relationship Between Tower-Shaped Bladder and Associated Factors [n (%)]\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"top\" style=\"width: 321px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 197px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTower-Shaped Bladder\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003eAbsent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 114px;\"\u003e\n \u003cp\u003ePresent\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEthnicity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003eTurkish\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e41 (87,2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e89 (76,1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 83px;\"\u003e\n \u003cp\u003e0,167\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003eSyrian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e6 (12,8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e28 (23,9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"6\" valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEtiology of Neurogenic Bladder\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003eOperated MMC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e22 (46,8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e79 (67,5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"6\" style=\"width: 83px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003eSpina bifida\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e14 (29,8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e18 (15,4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003eVUR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e5 (10,6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e13 (11,1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003eARM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e1 (2,1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e2 (1,7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003eDSD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e4 (8,5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e3 (2,6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003eUrethral stricture\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e1 (2,1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e2 (1,7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge-Adjusted Serum Creatinine\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 158px;\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e46 (97,9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e100 (85,5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 83px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 158px;\"\u003e\n \u003cp\u003eAbove Normal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e1 (2,1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e9 (7,7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 158px;\"\u003e\n \u003cp\u003eTwice the Normal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e5 (4,3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 158px;\"\u003e\n \u003cp\u003eMarkedly Elevated\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e3 (2,6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDTPA Obstruction\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003eDTPA not performed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e44 (32,8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e90 (67,2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 83px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003ePresent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e2 (7,7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e24 (92,3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003eNo obstruction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e1 (25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e3 (75)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" style=\"width: 163px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBladder Volume at 40 cm/H₂O Pressure\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 158px;\"\u003e\n \u003cp\u003eNo high pressure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e41 (44,1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e52 (55,9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0,001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 158px;\"\u003e\n \u003cp\u003eAt full bladder\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e3 (33,3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e6 (66,7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 158px;\"\u003e\n \u003cp\u003eAt half bladder volume\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e3 (6,8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e41 (93,2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 158px;\"\u003e\n \u003cp\u003eAt quarter bladder volume\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e18 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 321px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCIC Duration\u0026nbsp;\u003c/strong\u003e(mean \u0026plusmn; SD) (month)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e14,6\u0026plusmn;32,4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 114px;\"\u003e\n \u003cp\u003e25,8\u0026plusmn;31,0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,041**\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 321px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge at CIC Initiation\u0026nbsp;\u003c/strong\u003e(mean \u0026plusmn; SD) (year)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e3,4\u0026plusmn;4,4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 114px;\"\u003e\n \u003cp\u003e5,7\u0026plusmn;4,7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e0,019**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e*Chi-square test \u0026nbsp; **Student\u0026rsquo;s t test\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable V. Comparison of bladder filling at 40 cm H₂O bladder pressure according to the clinical characteristics of the patients [n (%)]\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"top\" style=\"width: 215px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eClinical Characteristic\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" style=\"width: 322px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBladder filling at 40 cm H₂O bladder pressure\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 65px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003eNo high pressure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003eFull Filling\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003eHalf Filling\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eQuarter Filling\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMaternal folic acid use\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e37 (54,4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e5 (7,4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e19 (27,9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e7 (10,3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 65px;\"\u003e\n \u003cp\u003e0,814**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e56 (58,3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e4 (4,2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e25 (26)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e11 (11,5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVUR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003eAbsent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e55 (68,8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e4 (5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e14 (17,5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e7 (8,8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 65px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003eVUR Grade 1-3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e10 (62,5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e4 (25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e2 (12,5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003eVUR Grade 4-5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e28 (41,2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e5 (7,4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e26 (38,2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e9 (13,2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBilateral VUR\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003eAbsent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e79 (60,8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e6 (4,6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e32 (24,6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e13 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 65px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003ePresent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e14 (41,2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e3 (8,8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e12 (35,3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e5 (14,7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTower-shaped bladder\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003eAbsent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e41 (87,2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e3 (6,4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e3 (6,4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0,001\u003c/strong\u003e**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003ePresent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e52 (44,4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e6 (5,1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e41 (35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e18 (15,4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAnticholinergic treatment\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e49 (75,4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e2 (3,1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e11 (16,9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e3 (4,6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 65px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003eOxybutynin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e36 (54,5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e3 (4,5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e16 (24,2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e11 (16,7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003eTolterodine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e5 (31,3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e3 (18,8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e7 (43,8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e1 (6,3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003ePropiverine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e3 (17,6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e1 (5,9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e10 (58,8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e3 (17,6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePost-void residual (PVR\u003c/strong\u003e, mean \u0026plusmn; SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003eAble to walk\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e49,7\u0026plusmn;45,2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e89,7\u0026plusmn;81,1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e59,2\u0026plusmn;34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e48,4\u0026plusmn;21,3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e0,223\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003eUnable to walk\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e51,1\u0026plusmn;40,1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e55,4\u0026plusmn;24,3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e58,4\u0026plusmn;37,3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e0,938\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 215px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDuration of CIC\u0026nbsp;\u003c/strong\u003e(mean \u0026plusmn; SD, months)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e16,7\u0026plusmn;29,8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e23,8\u0026plusmn;30,7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e28\u0026plusmn;32,7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e39,6\u0026plusmn;33,4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e0,020\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 215px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge of CIC initiation\u003c/strong\u003e (mean \u0026plusmn; SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e5\u0026plusmn;4,8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e5,6\u0026plusmn;3,4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e5,8\u0026plusmn;4,9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e4,5\u0026plusmn;4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e0,785\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 215px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMaternal age\u0026nbsp;\u003c/strong\u003e(mean \u0026plusmn; SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e26,8\u0026plusmn;4,8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e24,8\u0026plusmn;3,2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e27,6\u0026plusmn;5,7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e26,3\u0026plusmn;6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e0,439\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e*ANOVA testi \u0026nbsp; \u0026nbsp; \u0026nbsp;** Chi-square test\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable VI. Changes in Intravesical Pressure in Patients Receiving Anticholinergic Therapy\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 260px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBladder pressure changes\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eP value*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo Change\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDecrease\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIncrease\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVUR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eAbsent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e12 (34,3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e19 (54,3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e4 (11,4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 86px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eVUR Grade 1-3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e2 (40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e2 (40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e1 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eVUR Grade 4-5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e11 (28,2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e16 (41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e12 (30,8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBilateral VUR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eAbsent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e19 (33,3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e29 (50,9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e9 (15,8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 86px;\"\u003e\n \u003cp\u003e0,134**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003ePresent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e6 (27,3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e8 (36,4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e8 (36,4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTower-shaped bladder\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eAbsent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e2 (14,3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e11 (78,6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e1 (7,1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 86px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003ePresent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e23 (35,4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e26 (40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e16 (24,6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 274px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBladder diameter ratio\u0026nbsp;\u003c/strong\u003e(mean \u0026plusmn; SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e1.484\u0026plusmn;0.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e1.379\u0026plusmn;0.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e1.549\u0026plusmn;0.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e0,085\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBladder pressure at 40 cm H₂O filling\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eNo high pressure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e12 (37,5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e18 (56,3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e2 (6,3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 86px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eFull bladder\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e3 (42,9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e3 (42,9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e1 (14,3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eHalf-filled bladder\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e7 (24,1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e13 (44,8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e9 (31)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eQuarter-filled bladder\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e3 (27,3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e3 (27,3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e5 (45,5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAnticholinergic\u003c/strong\u003e \u003cstrong\u003eused\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e2 (40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e2 (40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e1 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 86px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eOxybutynin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e10 (23,3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e22 (51,2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e11 (25,6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eTolterodine\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e11 (73,3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e1 (6,7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e3 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003ePropiverine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e2 (12,5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e12 (75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e2 (12,5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePVR\u0026nbsp;\u003c/strong\u003e(mean \u0026plusmn; SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eWalking\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e73,3\u0026plusmn;61,8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e50,9\u0026plusmn;35,7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e66,7\u0026plusmn;32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e0,391\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eNon-walking\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e48,5\u0026plusmn;22,8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e57\u0026plusmn;38,4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e50,8\u0026plusmn;26,5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e0,876\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCIC use\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e2 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e6 (60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e2 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 86px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e23 (33,3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e31 (44,9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e15 (21,7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 274px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDuration of CIC\u0026nbsp;\u003c/strong\u003e(mean \u0026plusmn; SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e35,5\u0026plusmn;33,1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e25,3\u0026plusmn;27,9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e38,4\u0026plusmn;40,7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e0,299\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 274px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge at CIC initiation\u0026nbsp;\u003c/strong\u003e(mean \u0026plusmn; SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e4,7\u0026plusmn;3,9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e6,3\u0026plusmn;4,5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 92px;\"\u003e\n \u003cp\u003e3,5\u0026plusmn;3,3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e0,080\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e*ANOVA test \u0026nbsp; \u0026nbsp; \u0026nbsp; ** Chi-square test\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable VII. Age-Adjusted Serum Creatinine Levels by Clinical Variables\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" style=\"width: 321px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge-Adjusted Serum Creatinine\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eP value*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNormal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAbove Normal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTwice the Normal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarkedly Elevated\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCIC use\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e39 (97,5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e1 (2,5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 57px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e107 (86,3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e9 (7,3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e5 (4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e3 (2,4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAnticholinergic used\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e60 (92,3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e3 (4,6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1 (1,5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1 (1,5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 57px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eOxybutynin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e61 (92,4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e3 (4,5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1 (1,5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1 (1,5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eTolterodine\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e11 (68,8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e2 (12,5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e2 (12,5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1 (6,3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003ePropiverine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e14 (82,4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e2 (11,8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1 (5,9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVUR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eAbsent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e76 (95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e1 (1,3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1 (1,3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e2 (2,5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 57px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eVUR Grade1-3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e15 (93,8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e1 (6,3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eVUR Grade 4-5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e55 (80,9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e8 (11,8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e4 (5,9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1 (1,5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBilateral VUR\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eAbsent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e120 (92,3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e4 (3,1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e3 (2,3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e3 (2,3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 57px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003ePresent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e26 (76,5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e6 (17,6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e2 (5,9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDuration of CIC\u0026nbsp;\u003c/strong\u003e(mean \u0026plusmn; SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e20,5\u0026plusmn;30,6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e43,9\u0026plusmn;38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e33,6\u0026plusmn;41,9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e37\u0026plusmn;30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0,093\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge at CIC initiation\u0026nbsp;\u003c/strong\u003e(mean \u0026plusmn; SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e4,9\u0026plusmn;4,6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e7,1\u0026plusmn;5,4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e6,8\u0026plusmn;5,4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e7,3\u0026plusmn;6,7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0,377\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDuration of Anticholinergic Use\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e9,5\u0026plusmn;18,8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e25,6\u0026plusmn;33,7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e45,2\u0026plusmn;59,6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e9,7\u0026plusmn;12,7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e*ANOVA test\u003c/p\u003e\n"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Neurogenic bladder, tower bladder, intravesical pressure, DMSA, vesicoureteral reflux, creatinine","lastPublishedDoi":"10.21203/rs.3.rs-6895753/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6895753/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study aimed to assess the prognostic significance of “tower bladder” morphology in pediatric patients with neurogenic bladder, focusing on its association with radiological and urodynamic indicators and its predictive value for renal impairment.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMaterials and Methods:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe retrospectively reviewed 164 children (mean age: 7.7 ± 4.6 years) with neurogenic bladder managed at Gaziantep City Hospital between October 2023 and May 2024. Evaluations included voiding cystourethrography (VCUG) for bladder morphology and bladder diameter ratio (BDR), vesicoureteral reflux (VUR) grading, and dimercaptosuccinic acid (DMSA) scintigraphy for renal scarring. Urodynamic parameters, age-adjusted serum creatinine, timing of clean intermittent catheterization (CIC), and anticholinergic therapy duration were recorded.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTower bladder morphology was observed in 71.3% of patients and was significantly associated with higher intravesical pressure (46.2 ± 24.2 vs. 26.7 ± 19.1 cmH₂O; p \u0026lt; 0.001), elevated BDR (p \u0026lt; 0.001), high-grade VUR (p = 0.006), and increased renal scarring (p = 0.020). Late CIC initiation was linked to tower bladder (p = 0.019). Although anticholinergic therapy reduced pressure (p \u0026lt; 0.001), it had limited effect on renal preservation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTower bladder is a morphological marker of poor prognosis in pediatric neurogenic bladder, correlating with high intravesical pressure and renal risk. Early CIC and pharmacotherapy are essential to prevent irreversible damage. Integration of radiologic and functional data is critical for individualized risk assessment and management planning.\u003c/p\u003e","manuscriptTitle":"Tower Bladder: A Silent Threat in Pediatric Neurogenic Bladder – An Evaluation of Clinical Outcomes Based on Radiological and Urodynamic Markers","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-06-25 09:35:50","doi":"10.21203/rs.3.rs-6895753/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"17ed2794-5539-4469-966c-5cb4617edf72","owner":[],"postedDate":"June 25th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-08-04T18:38:42+00:00","versionOfRecord":[],"versionCreatedAt":"2025-06-25 09:35:50","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6895753","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6895753","identity":"rs-6895753","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}