Bael An, Winkler Pauline, Lax Hildegard, Hirche Herbert, Gäbel Elisabeth, Vijverberg Marianne, van Zon Roelie, Van Hoecke Eline, van Gool Jan D
Department of Pediatric Nephrology, University Hospital Antwerp, Wilrijkstraat 10, B-2650 Edegem, Belgium.
Pediatrics. 2008 May;121(5):e1196-200. doi: 10.1542/peds.2007-1652.
The purpose of this work was to analyze prospectively the prevalence of behavioral disorders in children with urinary incontinence because of nonneuropathic bladder-sphincter dysfunction before and after treatment for incontinence.
A total of 202 children with nonneuropathic bladder-sphincter dysfunction were enrolled in the European Bladder Dysfunction Study, in branches for urge syndrome (branch 1) and dysfunctional voiding (branch 2); 188 filled out Achenbach's Child Behavior Checklist before treatment and 111 after treatment. Child Behavior Checklist scales for total behavior problems were used along with subscales for externalizing problems and internalizing problems.
After European Bladder Dysfunction Study treatment, the total behavior problem score dropped from 19% to 11%, the same prevalence as in the normative population; in branch 1 the score dropped from 14% to 13%, and in branch 2 it dropped from 23% to 8%. The prevalence of externalizing problems dropped too, from 12% to 8%: in branch 1 it was unchanged at 10%, and in branch 2 it dropped from 14% to 7%. The decrease in prevalence of internalizing problems after treatment, from 16% to 14%, was not significant.
More behavioral problems were found in dysfunctional voiding than in urge syndrome, but none of the abnormal scores related to the outcome of European Bladder Dysfunction Study treatment for incontinence. With such treatment, both the total behavior problem score and the score for externalizing problems returned to normal, but the score for internalizing problems did not change. The drops in prevalence are statistically significant only in dysfunctional voiding.
本研究旨在前瞻性分析因非神经源性膀胱括约肌功能障碍导致尿失禁的儿童在尿失禁治疗前后行为障碍的患病率。
共有202例非神经源性膀胱括约肌功能障碍患儿参与了欧洲膀胱功能障碍研究,分为急迫性综合征组(第1组)和排尿功能障碍组(第2组);188例患儿在治疗前填写了阿肯巴克儿童行为量表,111例在治疗后填写。使用了儿童行为量表的总行为问题量表以及外化问题和内化问题的子量表。
经过欧洲膀胱功能障碍研究治疗后,总行为问题得分从19%降至11%,与正常人群患病率相同;第1组得分从14%降至13%,第2组从23%降至8%。外化问题的患病率也有所下降,从12%降至8%:第1组保持在10%不变,第2组从14%降至7%。治疗后内化问题患病率从16%降至14%,下降不显著。
排尿功能障碍组比急迫性综合征组发现更多行为问题,但与欧洲膀胱功能障碍研究尿失禁治疗结果相关的异常得分均无差异。经过此类治疗,总行为问题得分和外化问题得分均恢复正常,但内化问题得分未改变。患病率下降仅在排尿功能障碍组具有统计学意义。