Järvelin M R, Huttunen N P, Seppänen J, Seppänen U, Moilanen I
Department of Paediatrics, University of Oulu, Finland.
Scand J Urol Nephrol. 1990;24(3):181-9. doi: 10.3109/00365599009180856.
In order to detect possible urinary tract abnormalities among wetters, assessments of previous history completed by ultrasonography of the urinary tract and uroflowmetry were obtained for 145 wetting children and a random sample of 156 sex-matched non-wetting children drawn from a population of 3,375 seven-year-olds. Ultrasonography revealed abnormalities, including both morphological ones and cases with incomplete bladder emptying, in 5 out of 73 nightwetters (6.8%, 95% confidence limit, CL, 1.1-12.6), 10 out of 72 day and day and nightwetters (hereafter daywetters) (13.9%, CL 5.9-21.9) and 4 controls (2.6%, CL 0.1-5.0), the figure for the daywetters differing significantly from that for the controls (p less than 0.01). A fractioned voiding curve was recognized in 1 nightwetter (1.4%, CL -1.3-4.0), 7 daywetters (9.7%, CL 2.9-16.6) and 7 controls (4.5%, CL 1.2-7.7) the difference between the nightwetters and daywetters being significant (p less than 0.05). Depending on the previous history and abnormal findings in ultrasonography or uroflowmetry, examinations were continued with intravenous pyelography, voiding cystography, cystoscopy and/or by cystometry. Finally, marked structural or functional disorders of the urinary tract were detected in 11 out of 72 daywetters (15.3%, CL 7.0-23.6), 1 out of 73 pure nightwetters and 1 out of 156 control children. It is concluded that imaging of the urinary tract is not necessary for pure nightwetters, while ultrasonography or uroflowmetry and more sophisticated radiological or urological methods should be focused on those children with daytime wetting and clinical symptoms of voiding disturbances.
为了检测遗尿儿童可能存在的尿路异常情况，对145名遗尿儿童以及从3375名7岁儿童中随机抽取的156名性别匹配的非遗尿儿童进行了评估，通过尿路超声检查和尿流率测定来了解他们的既往病史。超声检查发现，73名夜间遗尿儿童中有5名（6.8%，95%置信区间，CL，1.1 - 12.6）存在异常，包括形态学异常以及膀胱排空不完全的情况；72名日间及日夜均遗尿儿童（以下简称日间遗尿儿童）中有10名（13.9%，CL 5.9 - 21.9）存在异常；156名对照儿童中有4名（2.6%，CL 0.1 - 5.0）存在异常，日间遗尿儿童的异常比例与对照儿童的异常比例差异显著（p小于0.01）。1名夜间遗尿儿童（1.4%，CL -1.3 - 4.0）、7名日间遗尿儿童（9.7%，CL 2.9 - 16.6）和7名对照儿童（4.5%，CL 1.2 - 7.7）出现了分段排尿曲线，夜间遗尿儿童和日间遗尿儿童之间的差异显著（p小于0.05）。根据既往病史以及超声检查或尿流率测定的异常结果，继续进行静脉肾盂造影、排尿性膀胱尿道造影、膀胱镜检查和/或膀胱测压检查。最终，72名日间遗尿儿童中有11名（15.3%，CL 7.0 - 23.6）、73名单纯夜间遗尿儿童中有1名以及156名对照儿童中有1名被检测出存在明显的尿路结构或功能紊乱。研究得出结论，对于单纯夜间遗尿儿童，无需进行尿路成像检查，而对于有日间遗尿和排尿障碍临床症状的儿童，应重点进行超声检查或尿流率测定以及更复杂的放射学或泌尿学检查。
