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首页> 外文期刊>Progres en urologie: journal de l’Association francaise d’urologie et de la Societefrancaise d’urologie >Childhood sexual abuse: How important is the diagnosis to understand and manage sexual, anorectal and lower urinary tract symptoms [Abus sexuels dans l'enfance: Intérêt de leur diagnostic pour la compréhension et la prise en charge des troubles sexuels, ano-rectaux et vésico-sphinctériens]
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Childhood sexual abuse: How important is the diagnosis to understand and manage sexual, anorectal and lower urinary tract symptoms [Abus sexuels dans l'enfance: Intérêt de leur diagnostic pour la compréhension et la prise en charge des troubles sexuels, ano-rectaux et vésico-sphinctériens]

机译：儿童性虐待：诊断对于理解和管理性，肛门直肠和下尿路症状有多重要[儿童性虐待：他们的诊断对于了解和管理性，肛门直肠和囊泡性疾病的兴趣-sphinctériens]

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Objective: To understand and manage the sequels of childhood sexual abuse on sexual, anorectal and lower urinary tract functions. Material and methods: Review of articles published in the Medline database, selected according to their scientific relevance and published guidelines on this subject together with our own experience. Results: A history of sexual abuse is frequently found when assessing dysfunction or symptoms of the lower urinary tract. In this context, urinary stress incontinence is rarely involved but it can be linked by epidemiological factors. Dysuria with urgency is the most frequent expressed symptom. When associated with anorectal disorders and pelvic pain or a sexual disorder in particular dyspareunia, a sexual abuse should be evoked and specific questions asked to the patient. Although these symptoms are frequently encountered in 12to 33% of women, and 8to 16% of men, few practitioners, whatever their speciality ask about them as routine. It is important that the physician diagnose the existence of sexual abuse, in particular when the symptoms mentioned by the patient are not conclusive, in spite of thorough urological assessment. Patients finding the initial examination difficult and painful and the failure of the initial treatment should lead to questions concerning abuse, if neglected by the initial medical inquiry. Conclusions: Clinicians involved in perineal functional pathology are able to acquire standardized modalities of inquiry about child sexual abuse for a better time management and efficacy in the therapeutic approach. The interest of a multidisciplinary diagnostic and therapeutic approach is primordial, associating psychological therapy and if necessary perineal re-education. This can avoid unnecessary tests and out-patient visits. Directing patients towards a multidisciplinary approach is highly advisable.
机译：目的：了解和管理儿童期性虐待对性，肛门直肠和下尿路功能的影响。材料和方法：审阅Medline数据库中发表的文章，根据其科学意义进行选择，并根据自己的经验发表关于该主题的指南。结果：在评估功能障碍或下尿路症状时经常发现性虐待史。在这种情况下，很少涉及尿失禁，但可以与流行病学因素联系在一起。尿痛伴尿急是最常见的症状。当与肛门直肠疾病和骨盆疼痛或性功能障碍，特别是性交困难有关时，应引起性虐待，并向患者提出具体问题。尽管这些症状在12％至33％的女性和8％至16％的男性中经常遇到，但很少有医生从业，无论他们的专业要求如何。重要的是，尽管进行了全面的泌尿科评估，医师仍应诊断出性虐待的存在，特别是当患者提到的症状尚无定论时。如果最初的医疗询问忽视了患者，则发现进行初始检查的困难和痛苦以及初始治疗的失败应导致有关滥用的问题。结论：会阴功能性病理学的临床医生能够获得有关儿童性虐待的标准化查询方式，以便在治疗方法中获得更好的时间管理和疗效。多学科诊断和治疗方法的兴趣是原始的，将心理治疗与必要时的会阴再教育联系起来。这样可以避免不必要的测试和门诊。强烈建议将患者引导至多学科方法。

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