Division of Urology, Red Cross Children's Hospital, University of Cape Town, Rondebosch 7701, Cape Town, South Africa.
Nat Rev Urol. 2009 Dec;6(12):671-4. doi: 10.1038/nrurol.2009.214. Epub 2009 Nov 10.
Pediatric neuropathic bladder dysfunction can cause irreversible renal damage and urinary incontinence. Etiologically, it is usually the consequence of a congenital neural tube defect. The majority of affected children can be successfully managed with the standard medical treatment of clean intermittent catheterization and anticholinergic (typically oxybutynin) medication. A subset of patients experience severe side effects or insufficient suppression of detrusor overactivity on oral oxybutynin. Intravesical instillations offer an effective alternative; this Review considers their indications, administration, safety and efficacy.
小儿神经性膀胱功能障碍可导致不可逆转的肾损伤和尿失禁。从病因学上讲,它通常是先天性神经管缺陷的结果。大多数受影响的儿童可以通过标准的医疗治疗,即清洁间歇性导尿和抗胆碱能药物(通常是奥昔布宁)成功管理。少数患者口服奥昔布宁会出现严重副作用或对逼尿肌过度活动的抑制作用不足。膀胱内灌注提供了一种有效的替代方法;本综述考虑了它们的适应证、给药方式、安全性和疗效。