Mahler Birgitte, Hagstroem Soren, Rittig Nikolaj, Mikkelsen Mette Marie, Rittig Soren, Djurhuus Jens Christian
Clinical Institute, University of Aarhus, Aarhus, Denmark.
J Urol. 2008 Jun;179(6):2384-8. doi: 10.1016/j.juro.2008.01.168. Epub 2008 Apr 23.
Daytime voiding frequency is an important criterion in the classification of childhood incontinence. The aim of this study was to assess the relative impact of diuresis and bladder capacity on voiding frequency.
We analyzed data from 570 children 4 to 15 years old (median age 8.3 +/- 2.0 years) treated for urinary incontinence at a secondary referral center, and 87 healthy controls. Based on frequency-volume charts, daytime voiding frequency, age adjusted maximum voided volume, daytime diuresis and fluid intake were calculated. Children were classified according to voiding frequency into 3 groups-decreased (fewer than 3 voids daily), normal (3 to 7) and increased voiding frequency (more than 7).
A total of 219 children had monosymptomatic enuresis, while 351 children presented with daytime symptoms. In children with daytime symptoms we found a significant difference between voiding frequency groups regarding daytime diuresis (decreased voiding frequency 12.3 +/- 4.1 ml/kg, normal 18.7 +/- 6.0 ml/kg, increased 31.1 +/- 9.8 ml/kg, p <0.001). In contrast, maximum voided volume observed/expected bladder capacity for age did not differ significantly between normal and increased frequency groups (72% +/- 25% vs 74% +/- 23%), compared to patients with decreased voiding frequency (89% +/- 30%, p <0.01). Also, in healthy children we found a positive correlation between voiding frequency and daytime diuresis, whereas maximum voided volume observed/expected bladder capacity for age did not correlate with voiding frequency. Furthermore, we observed a significant positive correlation between fluid intake and diuresis (r = 0.53, p <0.001).
In healthy controls and children with incontinence daytime voiding frequency depends mainly on diuresis, and seems less influenced by bladder capacity. Diuresis should be taken into consideration when evaluating voiding frequency from frequency-volume charts in children.
白天排尿频率是儿童尿失禁分类的重要标准。本研究的目的是评估利尿和膀胱容量对排尿频率的相对影响。
我们分析了在二级转诊中心接受尿失禁治疗的570名4至15岁儿童（中位年龄8.3±2.0岁）的数据，以及87名健康对照者的数据。根据频率-容量图表，计算白天排尿频率、年龄校正后的最大排尿量、白天尿量和液体摄入量。根据排尿频率将儿童分为3组——排尿减少（每天少于3次排尿）、正常（3至7次）和排尿频率增加（超过7次）。
共有219名儿童患有单纯性遗尿症，而351名儿童有白天症状。在有白天症状的儿童中，我们发现排尿频率组之间在白天尿量方面存在显著差异（排尿减少组12.3±4.1ml/kg，正常组18.7±6.0ml/kg，增加组31.1±9.8ml/kg，p<0.001）。相比之下，正常频率组和增加频率组观察到的最大排尿量/预期年龄膀胱容量与排尿减少的患者相比，差异无统计学意义（72%±25%对74%±23%，p<0.01）。此外，在健康儿童中，我们发现排尿频率与白天尿量之间存在正相关，而观察到的最大排尿量/预期年龄膀胱容量与排尿频率无关。此外，我们观察到液体摄入量与尿量之间存在显著正相关（r=0.53，p<0.001）。
在健康对照者和尿失禁儿童中，白天排尿频率主要取决于尿量，似乎受膀胱容量的影响较小。在根据频率-容量图表评估儿童排尿频率时，应考虑尿量。
