Ganesan V, Borzyskowski M
The Wolfson Centre, London, UK.
Dev Med Child Neurol. 2001 Jul;43(7):473-5. doi: 10.1017/s001216220100086x.
Bladder involvement is common in transverse myelitis but its characteristics and natural history, particularly in relation to neurological outcome, have not been described in a paediatric population previously. Ten children, with ages ranging from 8 months to 16 years, who had a diagnosis of acute transverse myelitis were studied with video urodynamics and followed up in a tertiary paediatric neurourology clinic. Nine of ten children had obstructive urinary tract symptoms at presentation and all went on to develop 'irritative' urinary tract symptoms (frequency and urgency) about 1 month after initial presentation. Video urodynamics showed a combination of irritative (detrusor hyperreflexia) and obstructive (detrusor-sphincter dyssynergia) abnormalities in most patients and enabled management to be specifically directed towards these. The patients progress was followed up for a median duration of 36 months. All had residual bladder dysfunction, only four were asymptomatic on treatment. The degree of recovery of bladder function was not related to the degree of motor recovery.
膀胱受累在横贯性脊髓炎中很常见，但其特征和自然史，尤其是与神经学转归相关的情况，此前在儿科人群中尚未有过描述。对10名年龄在8个月至16岁之间、诊断为急性横贯性脊髓炎的儿童进行了影像尿动力学研究，并在一家三级儿科神经泌尿外科诊所进行随访。10名儿童中有9名在就诊时出现梗阻性尿路症状，且在初次就诊后约1个月均继而出现“刺激性”尿路症状（尿频和尿急）。影像尿动力学显示，大多数患者存在刺激性（逼尿肌反射亢进）和梗阻性（逼尿肌-括约肌协同失调）异常的组合，这使得能够针对这些异常进行具体的治疗。对患者进行了中位时长36个月的随访。所有患者均有残余膀胱功能障碍，只有4名在治疗后无症状。膀胱功能的恢复程度与运动恢复程度无关。
