Evaluation of the utility of video-urodynamics in children with urinary tract infection and voiding dysfunction
Evaluation of the utility of video-urodynamics in children with urinary tract infection and voiding dysfunction
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DOI：
10.1046/j.1464-410x.1997.00447.x
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发表时间：
1997-11-01
期刊：
影响因子：
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通讯作者：
Barone, JG
中科院分区：
文献类型：
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作者：
Glazier, DB;Murphy, DP;Barone, JG
目的探讨视频尿动力学检查（VUDS）在儿童尿路感染（UTI）中的应用价值（频率，紧迫性，失禁），以确定VUDS是否显著有助于诊断和决定治疗。在我们中心看到的所有患有UTI并伴有提示排尿功能障碍的既往症状的儿童均接受了自由和压力流VUDS，42名儿童进行VUDS和38（平均年龄9岁，范围4-16，15名男性，23名女性）有足够的信息被列入研究。只有5名患者被发现有反流，其中3人有相关的逼尿肌不稳定。此外，33例无反流的患者中有24例尿动力学检查异常，其中最常见的问题是逼尿肌不稳定，24例患者中有17例。其他异常包括括约肌协同失调（5例），膀胱顺应性差（2）和超敏反应膀胱filling.Conclusion VUDS可以提供有关UTI和排尿功能障碍的儿童，不能从任何其他来源的病因信息。VUDS的结果可用于选择特定的治疗，以避免不适当的治疗，并确定儿童谁可能受益于后续研究，尽管正常的结果排尿膀胱尿道造影。从这些结果，我们认为，VUDS应考虑与UTI和排尿功能障碍的儿童。
Objective To assess the use of video-urodynamic studies (VUDS) in children with urinary tract infection (UTI) and symptoms of voiding dysfunction (frequency, urgency, incontinence), to ascertain whether VUDS significantly assists in diagnosis and deciding treatment.Patients and methods Over a 16-month period, all children seen at our centre with a UTI in conjunction with previous symptoms suggestive of voiding dysfunction underwent free and pressure-flow VUDS, Forty-two children underwent VUDS and 38 (mean age 9 years, range 4-16, 15 male, 23 female) had sufficient information to be included in the study.Results All children had a prior history of voiding dysfunction (mean 55 months). Only five patients were found to have reflux and three of these had associated detrusor instability. In addition, 24 of 33 patients who did not have reflux had abnormalities on urodynamic study, the most common problem being detrusor instability in 17 of 24 patients. Other abnormalities included sphincter dyssynergia (five patients), poor bladder compliance (two) and hypersensitivity on bladder filling (three).Conclusion VUDS can provide information about the aetiology of UTI and voiding dysfunction in children that cannot be obtained from any other source. The results of VUDS can be used to select specific treatments, to avoid inappropriate therapy and to identify children who may benefit from follow-up studies despite normal findings on voiding cystourethrography. From these results, we believe that VUDS should be considered for children with UTI and voiding dysfunction.