Voiding Disorders in Pediatrician's Practice.

IF 1.7 Q2 PEDIATRICS Clinical Medicine Insights-Pediatrics Pub Date : 2020-11-27 eCollection Date: 2020-01-01 DOI:10.1177/1179556520975035
Magda Rakowska-Silska, Katarzyna Jobs, Aleksandra Paturej, Bolesław Kalicki
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引用次数: 5

Abstract

Voiding disorders result usually from functional disturbance. However, relevant organic diseases must be excluded prior to diagnosis of functional disorders. Additional tests, such as urinalysis or abdominal ultrasound are required. Further diagnostics is necessary in the presence of alarm symptoms, such as secondary nocturnal enuresis, weak or intermittent urine flow, systemic symptoms, glucosuria, proteinuria, leukocyturia, erythrocyturia, skin lesions in the lumbar region, altered sensations in the perineum. Functional micturition disorders were thoroughly described in 2006, and revised in 2015 by ICCS (International Children's Continence Society) and are divided into storage symptoms (increased and decreased voiding frequency, incontinence, urgency, nocturia), voiding symptoms hesitancy, straining, weak stream, intermittency, dysuria), and symptoms that cannot be assigned to any of the above groups (voiding postponement, holding maneuvers, feeling of incomplete emptying, urinary retention, post micturition dribble, spraying of the urinary stream). Functional voiding disorders are frequently associated with constipation. Bladder and bowel dysfunction (BBD) is diagnosed when lower urinary tract symptoms are accompanied by problems with defecation. Monosymptomatic enuresis is the most common voiding disorder encountered by pediatricians. It is diagnosed in children older than 5 years without any other lower urinary tract symptoms. Other types of voiding disorders such as: non-monosymptomatic enuresis, overactive and underactive bladder, voiding postponement, bladder outlet obstruction, stress or giggle incontinence, urethrovaginal reflux usually require specialized diagnostics and therapy. Treatment of all types of functional voiding disorders is based on non-pharmacological recommendations (urotherapy), and such education should be implemented by primary care pediatricians.

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儿科医生实践中的排尿障碍。
排尿障碍通常由功能障碍引起。然而,在诊断功能障碍之前,必须排除相关的器质性疾病。需要进行额外的检查,如尿液分析或腹部超声检查。如果出现警示症状,如继发性夜间遗尿、微弱或间歇性尿流、全身症状、血糖、蛋白尿、白细胞尿、红细胞尿、腰部皮肤病变、会阴部感觉改变等,则需要进一步诊断。排尿功能障碍是彻底的描述,2006年修订后的2015年,可以(国际儿童自制协会)和症状分为存储(增加和减少排尿的频率,尿失禁,紧迫感,夜尿症),排尿症状犹豫,紧张,弱流,间歇性,排尿困难),症状不能分配给任何上述团体(排泄推迟,举行演习,排空的感觉,尿潴留,排尿后滴、喷的尿流)。功能性排尿障碍常与便秘有关。当下尿路症状伴有排便问题时,诊断为膀胱和肠道功能障碍(BBD)。单症状性遗尿是儿科医生遇到的最常见的排尿障碍。5岁以上儿童无其他下尿路症状。其他类型的排尿障碍,如:非单症状性遗尿、膀胱过度活跃和不活跃、排尿延迟、膀胱出口阻塞、压力或咯咯声失禁、尿道阴道反流等,通常需要专门的诊断和治疗。所有类型的功能性排尿障碍的治疗都是基于非药物建议(泌尿治疗),这样的教育应该由初级保健儿科医生实施。
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