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首页> 外文期刊>BJU international >The usefulness of a minimal urodynamic evaluation and pelvic floor biofeedback in children with chronic voiding dysfunction.
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The usefulness of a minimal urodynamic evaluation and pelvic floor biofeedback in children with chronic voiding dysfunction.

机译：最小的尿流动力学评估和骨盆底生物反馈在慢性排尿功能障碍儿童中的有用性。

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OBJECTIVE: To report our experience of assessing children with chronic voiding dysfunction (>6 months' duration) using a minimal urodynamic evaluation, and the management of detrusor-sphincter dyscoordination (DSdc) using pelvic floor biofeedback. PATIENTS AND METHODS: From 1994 to 1997, 120 children (mean age 7.5 years) with three predominant and associated symptoms were referred to one urologist; they had nocturnal enuresis (28 children), urge incontinence (42) or urinary tract infection (50). All patients were assessed by urinary culture, renal ultrasonography and a minimal urodynamic evaluation, i.e. urinary flowmetry with sphincter electromyography (EMG) using perineal surface electrodes. If they had urinary tract infection and/or renal dilatation, they underwent voiding cysto-urethrography. In children with DSdc, urinary training with frequent voiding was instituted initially, with subsequent pelvic floor biofeedback exercises if the improvement was deemed unsatisfactory. RESULTS: DSdc was diagnosed in 33 children (28%), none of whom had isolated nocturnal enuresis. Pelvic floor biofeedback was undertaken by 15 children (12 girls and three boys); it was well accepted because it was administered as a computer game. In all affected patients the DSdc resolved on EMG and there was a significant clinical improvement. Vesico-ureteric reflux was detected in 24 patients, associated with DSdc in 10. The reflux resolved spontaneously on antibiotic prophylaxis in six children and after urinary re-education in four. CONCLUSION: A minimal urodynamic evaluation seems to be useful in the diagnosis of DSdc which caused urinary tract infection and/or bladder overactivity. The results with pelvic floor biofeedback were excellent in these children.
机译：目的：报告我们通过最小尿流动力学评估评估慢性排尿功能障碍（持续时间> 6个月）儿童的经验，并通过骨盆底生物反馈治疗逼尿肌括约肌功能障碍（DSdc）。患者与方法：1994年至1997年，将120名患有三种主要及相关症状的儿童（平均年龄7.5岁）转诊给一名泌尿科医师。他们有夜间遗尿症（28名儿童），急迫性尿失禁（42名）或尿路感染（50名）。所有患者均通过尿液培养，肾脏超声检查和最小尿流动力学评估进行评估，即使用会阴表面电极通过括约肌肌电图（EMG）进行尿流测定。如果他们有尿路感染和/或肾脏扩张，则应进行膀胱尿道造影。对于患有DSdc的儿童，最初会进行排尿频繁的排尿训练，如果认为这种改善不能令人满意，则进行随后的骨盆底生物反馈锻炼。结果：DSdc被诊断为33名儿童（28％），他们中没有一个人患有夜间遗尿症。 15名儿童（12名女孩和3名男孩）进行了骨盆底生物反馈。它被广泛接受，因为它是作为计算机游戏进行管理的。在所有受影响的患者中，DSdc在EMG上均消失，并且临床上有明显改善。在24例患者中发现了膀胱输尿管反流，其中10例与DSdc相关。在6例儿童中，由于预防性使用抗生素而自发解决了返流，在4例儿童接受了尿液再教育后，反流得到了自发解决。结论：最小尿流动力学评估似乎可用于诊断导致尿路感染和/或膀胱过度活动的DSdc。在这些儿童中，骨盆底生物反馈的结果非常好。

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