Br J Gen Pract. 1990 Apr;40(333):146-9.
Thirteen general practitioners examined the notes of 1072 patients born in 1974 for evidence of enuresis, suspected urinary tract infection, and renal tract imaging. Of these children 63 (5.9%) had presented with enuresis -6.7% of the boys and 5.0% of the girls. Of the 63 children 65.1% had had midstream urinalysis. One hundred and ninety five children (18.2%, 64 boys and 131 girls) had experienced 303 episodes of possible urinary infections. Midstream urine samples were obtained in 80.2% of episodes and 17.7% of samples were positive. Ten boys (1.9% of the total) and 28 girls (5.2%) had proven infections. Only 14 of these 38 children (36.8%) had undergone renal tract imaging, 30.9% of the boys and 39.3% of the girls. All imaging was normal except in the case of one girl whose micturating cystourethrogram showed reflux. Fifteen other children were investigated; two further abnormalities were detected, one renal scar with reflux and one duplex system. This study demonstrates deficiencies in the investigation and follow up of children with urinary problems by general practitioners. Possible means of improvement are discussed.
13名全科医生检查了1974年出生的1072名患者的病历，以寻找遗尿、疑似尿路感染和肾脏影像学检查的证据。在这些儿童中，63名（5.9%）曾出现遗尿——男孩为6.7%，女孩为5.0%。在这63名儿童中，65.1%进行了中段尿分析。195名儿童（18.2%，64名男孩和131名女孩）经历了303次可能的尿路感染发作。80.2%的发作采集了中段尿样本，17.7%的样本呈阳性。10名男孩（占总数的1.9%）和28名女孩（5.2%）被证实感染。在这38名儿童中，只有14名（36.8%）接受了肾脏影像学检查，男孩为30.9%，女孩为39.3%。除了一名女孩的排尿性膀胱尿道造影显示有反流外，所有影像学检查均正常。另外对15名儿童进行了检查；又发现了两例异常，一例是伴有反流的肾瘢痕，另一例是重复肾系统。这项研究表明，全科医生对有泌尿系统问题的儿童的检查和随访存在不足。文中讨论了可能的改进方法。
