Rudy D C, Woodside J R
University of Texas Medical School, Houston.
Urol Clin North Am. 1991 May;18(2):295-308.
Urinary incontinence is a socially devastating aspect of the lives of many myelodysplastic children. Incontinence results from abnormal bladder storage function, urethral sphincteric incompetence, or both. Unfortunately, the vesicourethral dysfunction in an individual patient cannot be discerned from the level of the vertebral defect or the coexisting neurologic deficits. Therefore, thorough urodynamic assessment is required to identify altered physiology precisely and to guide rational treatment. Our therapeutic armamentarium includes external devices, intermittent self-catheterization, pharmacologic therapy, prosthetics, electrical stimulation, biofeedback, and innovative surgical procedures. Comprehensive evaluation, thoughtful tailoring of therapy to the individual patient, and a commitment by the urologist to indefinite follow-up will enable most patients to attain social continence while preserving renal function.
尿失禁是许多骨髓发育不良儿童生活中一个对社会有严重影响的方面。尿失禁是由膀胱储存功能异常、尿道括约肌功能不全或两者共同引起的。不幸的是，无法从脊柱缺损的程度或并存的神经功能缺损来判断个体患者的膀胱尿道功能障碍。因此，需要进行全面的尿动力学评估，以准确识别生理功能的改变并指导合理的治疗。我们的治疗手段包括外部装置、间歇性自我导尿、药物治疗、假体、电刺激、生物反馈和创新的外科手术。全面评估、根据个体患者情况精心调整治疗方案以及泌尿科医生进行无限期随访的承诺，将使大多数患者在保持肾功能的同时实现社会可接受的控尿。
