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Vesicoureteral reflux-the role of bladder and bowel dysfunction

机译：膀胱输尿管反流-膀胱和肠功能障碍的作用

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摘要

Vesicoureteral reflux (VUR) is a significant risk factor for clinical pyelonephritis and renal scarring. In 2010, the American Urological Association (AUA) reported that bladder and bowel dysfunction (BBD), which is common in patients with VUR, increases the risk of breakthrough UTI in children receiving antibiotic prophylaxis, reduces the success rate for endoscopic injection therapy, and increases the risk of postoperative UTI, irrespective of the surgical success rate for VUR. Accordingly, physicians are strongly recommended to investigate BBD in their patients with VUR. Symptoms and signs of BBD include urinary frequency and urgency, prolonged voiding intervals, daytime wetting, perineal and penile pain, holding manoeuvres (posturing to prevent wetting), constipation, and encopresis. Primary assessment tools include the Pediatric Symptom Checklist, urinalysis, urine culture, bladder diary, measurement of the postvoid residual urine volume, Dysfunctional Voiding Symptom Score, uroflow with electromyography, and Bristol Stool Form Score. The Rome III criteria can also be used for diagnostic assessment of bowel function. Treatment of BBD should be individualized, directed at symptomatic and objective improvement, and can include behavioural modification, biofeedback, selective use of anticholinergics and α-blockers, and bowel management.
机译：膀胱输尿管反流（VUR）是临床肾盂肾炎和肾脏瘢痕形成的重要危险因素。 2010年，美国泌尿科协会（AUA）报告说，VUR患者常见的膀胱和肠功能障碍（BBD）增加了接受抗生素预防的儿童突破性尿道感染的风险，降低了内窥镜注射疗法的成功率，并且无论手术的VUR成功率如何，都会增加术后UTI的风险。因此，强烈建议医师对VUR患者进行BBD检查。 BBD的症状和体征包括尿频和尿急，排尿间隔时间延长，白天湿润，会阴和阴茎疼痛，保持动作（防止湿润的姿势），便秘和便秘​​。主要评估工具包括小儿症状检查表，尿液分析，尿液培养，膀胱日记，排尿后残余尿量的测量，功能障碍性空肠症状评分，肌电图检查尿流和布里斯托尔凳形式评分。 Rome III标准也可用于肠功能的诊断评估。 BBD的治疗应个体化，以症状和客观改善为目标，并且可以包括行为改变，生物反馈，抗胆碱能药和α受体阻滞剂的选择性使用以及肠道管理。

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